凝血四项及血清PCT、D-D水平变化与脓毒症患者病情程度关联性分析

Correlation Analysis Between Four Changes of Blood Coagulation and Serum PCT and D-D levels and Severity of Sepsis Patients

目的:探讨凝血四项[凝血酶原时间(PT)、活化凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)]及血清降钙素原(PCT)、D-二聚体(D-D)水平变化与脓毒症患者病情程度的相关性。方法:选取脓毒症患者115例作为观察组,另选同期呼吸道感染患者80例作为对照组,健康体检者60例作为健康对照组。均行凝血四项、血清PCT、D-D水平检测,比较3组上述指标水平,分析上述指标水平变化与脓毒症病情程度的相关性。结果:观察组PT、APTT、TT、血清PCT、D-D水平高于对照组、健康对照组,FIB低于对照组、健康对照组(P<0.05);脓毒性休克组患者PT、APTT、TT、血清PCT、D-D水平高于严重脓毒症组患者,FIB低于严重脓毒症组患者,严重脓毒症组患者PT、APTT、TT、血清PCT、D-D水平高于脓毒症组患者,FIB低于脓毒症组患者(P<0.05);PT、APTT、TT、血清PCT、D-D水平与脓毒症病情程度呈正相关,FIB与脓毒症病情程度呈负相关(P<0.05)。结论:脓毒症病情程度愈严重,PT、APTT、TT、血清PCT、D-D水平愈高,FIB水平愈低,可为临床诊断及病情评估提供依据。

Objective: To investigate the correlation between the four coagulation factors [prothrombin time(PT), activated thromboplastin time(APTT), thrombin time(TT), fibrinogen(FIB)] and the changes of serum procalcitonin(PCT), D-dimer(D-D) levels in patients with sepsis. Methods: 115 patients with sepsis were selected as the observation group, 80 patients with respiratory infection were selected as the control group, and 60 healthy subjects were used as the health control group. All four blood coagulation tests, serum PCT, D-D levels were measured, and the above-mentioned indicators were compared in the three groups. The correlation between the above-mentioned indicators and the severity of sepsis was analyzed. Results: The levels of PT, APTT, TT, serum PCT and DD in the observation group were higher than those in the control group and the health control group, FIB was lower than the control group and the health control group(P<0.05);the septic shock group was PT, APTT, TT, serum PCT, DD levels were higher than those in the severe sepsis group, FIB was lower than that in the severe sepsis group, and PT, APTT, TT, serum PCT, DD levels were higher in the severe sepsis group than that in the sepsis group. FIB was lower than that in the sepsis group(P<0.05);PT, APTT, TT, serum PCT, DD levels were positively correlated with the severity of sepsis, and FIB was negatively correlated with the severity of sepsis(P<0.05). Conclusion: The more severe the severity of sepsis, the higher the levels of PT, APTT, TT, serum PCT and D-D, and the lower the FIB level, which can provide a basis for clinical diagnosis and disease assessment.