D-二聚体与APACHE Ⅱ评分对急诊ICU发生DIC患者转归的判断价值

VALUE OF D-DIMER AND APACHE Ⅱ SCORE OCCURRED FOR OUTCOMES OF DIC PATIENTS IN THE EMERGENCY ICU

目的 分析D-二聚体（D-D）与APACHEⅡ评分对急诊重症监护病房（ICU）发生弥漫性小血管内凝血（DIC）患者转归的判断价值。方法 2012年3月~2013年12月我院急诊ICU发生DIC的患者86例,其中生存54例（生存组）,32例死亡（死亡组）,另选30例健康体检者（正常对照组）进行年龄、凝血因子凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）及凝血酶时间（TT）、D-二聚体（D-D）和纤维蛋白原（Fib）、抗凝血酶Ⅲ（AT-Ⅲ）检测、APACHEⅡ评分对照分析,论证D-D与APACHEⅡ评分能否判断急诊ICU发生DIC患者的转归。结果 年龄、凝血因子检测、APACHEⅡ评分结果显示,三组除Fib没有差异外（P〉0.05）,年龄、PT、TT、APTT、AT-Ⅲ、D-D水平及DIC生存组与DIC死亡组APACHEⅡ评分均有差异（P〈0.05,P〈0.01）。DIC生存组与DIC死亡组图示显示,两组D-D水平与APACHEⅡ评分有非常显著的差异。结论 血浆D-D水平与APACHEⅡ评分能反映急诊ICU发生DIC的患者的病情好转与恶化,但本研究DD水平与APACHEⅡ评分的域值能否作为患者生存与死亡的预测值,还有待进一步加大样本的研究。

Objective To analyze the value of D - dimer （ D - D） and APACHE Ⅱ score occurred for the DIC patient outcomes in the emergency ICU. Method 54 cases of survival （survival group） and 32 patients died （ mortality group） were 86 patients with DIC from our hospital emergency ICU. Another 30 healthy subjects （ control group） were selected from healthy. Age, coagulation factor prothrombin time （PT） , activated partial thromboplastin time （AFFF） and thrombin time （TF） , D - dimer （ D - D） and fibrinogen （Fib） , antithrombin m （ AT - m ） detection, APACHE Ⅱ score were comparatively analyzed between three groups. D - D and demonstration APACHE Ⅱ score can occur as outcomes of patients with DIC In the emergency ICU. Result Age, clotting factor detection resuits showed difference in the three groups except Fib outside （P 〈 0. 05, P 〈 0. 01 ）. APACHE Ⅱ scores were differences between DIC survival group and death group （P 〈0. 01 ）. Icons show DD levels and APACHE Ⅱ score were a very significant difference in DIC survival group and death group. Conclusion Plasma DD levels and APACHE Ⅱ score can reflect condition improved and deterioration of DIC patients in emergency ICU, but in this study whether DD threshold level and APACHE Ⅱ score are as the predicted value of patient survival and death. This need to be further increased the study sample.