清透明质酸水平及血小板相关参数在急诊脓毒症患者中预后价值分析

Prognostic values of serum hyaluronic acid level and platet related parameters in patients with sepsis

目的了解血清透明质酸水平及血小板相关参数与急诊脓毒症患者的预后间的关联。方法收集2015年1月-2019年1月蛘埠医学院第二附属医院经治急诊脓毒症患者80例(观察组),另招募健康志愿者(对照组)30例。抽取健康志愿者及患者入院24 h内外周静脉血8ml,分别测定血小板计数(PLT)、血小板分布宽度(PDW)、平均血小板体积(MPV)及大型血小板比例(P-LCR)等血小板相关参数和血清透明质酸水平。收集纳入患者性别、年龄、病程及发病3个月内病情转归(据此将观察组分为死亡组、存活组)等资料。结果与对照组比较,观察组血清透明质酸水平显著升高(P<0.05)。与存活组比较,死亡组血清透明质酸水平显著升高(P<0.05)。与对照组比较,观察组PLT显著降低,PDW及MPV均显著升高(均P<0.05);死亡组PLT显著降低,PDW及MPV均显著升高(均P<0.05);存活组PLT显著升高,P-LCR显著降低(均P<0.05)。与死亡组比较,存活组PDW、MPV及P-LCR均显著降低(均P<0.05)。血清透明质酸水平、PLT均为影响急诊脓毒症预后的独立危险因素(均P<0.05)。结论PLT、PDW、MPV、P-LCR及血清透明质酸水平均与急诊脓毒症预后相关,且随PLT降低和PDW、MPV、P-LCR及血清透明质酸水平升高病情渐重。

Objective To investigate the association between serum hyaluronic acid levels and platelet-related parameters and the prognosis of patients with acute sepsis.Methods 80 patients with sepsis(observation group)were divided into 2 sub-groups:death group(n.=54)and survival sub-group(n=26).were used as control group.Samples of peripheral venous blood was taken from 80 patients with sepsis(observation group)and 30 demographically matched healthy volunteers(control group)within 24 hours after admission to undergo measure the platelet related parameters:platelet count(PLT),platelet distribution width(PDW),mean platelet volume(MPV),and large platelet ratio(P-LCR)by CellaVision DM 96 automatic blood cell morphology analyzer,and test the serum hyaluronic acid lrvrl by ELISA.The observation group was divided into death sub-group(n=54)and survival sub-group(n=26)according to the disease outcome within 3 months.SPSS 23.0 software was used to analyze the data 3 months after admission.Results The serum hyaluronic acid level of the observation group was significantly higher than that of the control group(P<0.05);and the serum hyaluronic acid level of the death sub-group was significantly higher than that of the survival sub-group(P<0.05).The PLT of the observation group was significantly lower than that of the control group(P<0.05),and the PDW and MPV of the observation group were significantly higher than those of the control group(both P<0.05).The PLT of the survival sub-group was significantlyhigher than that of thedeath sub-group(P<0.05),and the PDW,MPV,and P-LCR of the survival sub-group were all significantly lower than those of the death sub-group(all P<0.05),Cox regression analysis showed that serum hyaluronic acid level and PLT were independent risk factors for the prognosis of sepsis(both P<0.05).Conclusion PLT,PDW,MPV,P-LCR and serum hyaluronic acid levels can provide an intervention basis for improving the prognosis of sepsis.With the decreasing of PLT and increasing of PDW,MPV,P-LCR and serum hyaluronic acid levels,the condition is getting heavier.