肺部感染合并脓毒症老年患者凝血功能变化及意义

Changes and significance of coagulation function in elderly patients with pulmonary infection complicated with sepsis

目的探讨肺部感染合并脓毒症老年患者凝血功能变化及意义。方法回顾性分析肺部感染合并脓毒症老年患者30例(脓毒症组)及同期肺部感染非脓毒症老年患者30例(对照组)的临床资料,比较两组患者外周血CRP、降钙素原(PCT)、凝血酶原时间(PT)、APTT、Plt及序贯器官衰竭评估(SOFA)评分。比较脓毒症患者死亡组(17例)与存活组(13例)上述指标有无统计学差异。采用Spearman相关分析观察上述指标与SOFA评分的相关性。结果脓毒症组PCT水平高于对照组,PT和APTT长于对照组,Plt水平低于对照组(P<0.01);而CRP水平与对照组比较无统计学差异(P>0.05)。脓毒症组中,死亡组PCT水平和SOFA评分均高于存活组,PT和APTT长于存活组,Plt水平低于存活组(P<0.01)。脓毒症患者SOFA评分与PCT、PT和APTT均呈正相关(rs=0.688、0.622和0.613,P<0.01),与Plt呈负相关(rs=-0.763,P<0.01)。结论肺部感染合并脓毒症老年患者存在凝血功能紊乱,并与病情密切相关。

Objective To explore the changes and significance of coagulation function in elderly patients with pulmonary infection complicated with sepsis.Methods The clinical data of 30 elderly patients with pulmonary infection and sepsis(group A)and 30 elderly patients with pulmonary infection without sepsis(group B)were retrospectively analyzed.The levels of CRP,procalcitonin(PCT),prothrombin time(PT),APTT,Plt and sequential organ failure assessment(SOFA)were compared between the two groups.The differences of above indicators were compared between the deaths(group D,17 cases)and the survivals(group S,13 cases)in group A.Spearman correlation analysis was used to evaluate the correlation of above indicators and SOFA score.Results Compared with group B,the level of PCT was higher,PT and APTT were longer,and Plt was lower in group A(P<0.01).There was no significant difference in CRP level between groups of A and B(P>0.05).Compared with group S,the patients group D had higher PCT and SOFA score,longer PT and APTT and lower Plt(P<0.01).The SOFA scores of patients with sepsis were positively correlated with PCT,PT and APTT(rs=0.688,0.622 and 0.613,P<0.01),but negatively correlated with Plt(rs=—0.763,P<0.01).Conclusion The coagulation disorder exists in elderly patients with pulmonary infection complicated with sepsis,which is closely related to the illness status.