血常规炎症因子及凝血功能在诊断脓毒血症中的临床应用

Clinical application of blood routine inflammatory factors and coagulation function in diagnosis of sepsis

目的分析血常规炎症因子、凝血功能在诊断脓毒血症中的价值。方法选取2020年1月—10月本院就诊的93例患者为研究对象,其中脓毒血症患者(n=41)作为观察组,非感染性全身炎症反应综合征患者(n=52)作为对照组,比较脓毒血症及非感染性全身炎症反应综合征患者入院24 h内的白细胞(WBC)、中性粒细胞(NC)、降钙素原(PCT)、血小板(PLT)、血小板分布宽度(PDW)、凝血酶原时间(PT)、平均血小板体积(MPV)、活化部分凝血活酶时间(APTT)水平;采用受试者工作特征曲线(ROC)下面积(AUC)评价相关炎症因子、凝血指标对脓毒血症的诊断价值。以28 d为观察终点,根据脓毒血症患者预后情况,将其分为存活组(n=25)和死亡组(n=16),比较存活组和死亡组患者入院24 h内的WBC、NC、PCT、PLT、PDW、PT、MPV、APTT水平;绘制ROC曲线,评价相关炎症因子、凝血指标对脓毒血症的预后评估价值。结果观察组PCT、PT、MPV、APTT水平均明显高于对照组(P<0.05),PLT水平明显低于对照组(P<0.05);PCT、PLT、PT、MPV、APTT对脓毒血症诊断的AUC值分别为0.784、0.626、0.644、0.671、0.710。存活组PDW、PT水平明显小于死亡组(P<0.05);PDW、PT对脓毒血症预后评估的AUC值分别为0.677、0.689。结论PCT、PLT、PT、MPV、APTT对脓毒血症的诊断具有一定临床价值,PDW、PT对脓毒血症的预后评估具有一定临床意义。

Objective To analyze the value of blood routine inflammatory factors and coagulation function in the diagnosis of sepsis.Methods A total of 93 patients in our hospital were selected from Jan.to Oct.2020,among which sepsis patients(n=41)were the observation group and non-infectious systemic inflammatory response syndrome patients(n=52)were the control group,and the levels of white blood cells(WBC),neutrophil(NC),procalcitonin(PCT),platelet(PLT),platelet distribution width(PDW),prothrombin time(PT),mean platelet volume(MPV),and activated partial thrombin time(APTT),which detected within 24 h after admission,in patients with sepsis and non-infectious systemic inflammatory response syndrome were compared;The area under the receiver operating characteristic(ROC)curve(AUC)was used to evaluate the diagnostic value of relevant inflammatory factors and coagulation indexes for sepsis.Taking 28 d as observation endpoint,sepsis patients were divided into survival group(n=25)and death group(n=16)according to the prognosis,and the levels of WBC,NC,PCT,PLT,PDW,PT,MPV and APTT,which were detected within 24 h after admission,were compared between the survival group and the death group;ROC curve was plotted to evaluate the prognostic value of relevant inflammatory factors and coagulation indexes for sepsis.Results The levels of PCT,PT,MPV,APTT of the observation group were significantly higher than those of the control group(P<0.05),and the PLT level of the observation group was significantly lower than that of the control group(P<0.05);The AUC values of PCT,PLT,PT,MPV and APTT for the diagnosis of sepsis were 0.784,0.626,0.644,0.671 and 0.710,respectively.The levels of PDW and PT of survival group were significantly smaller than those of death group(P<0.05);The AUC values of PDW and PT for the prognosis evaluation of sepsis were 0.677 and 0.689,respectively.Conclusion PCT,PLT,PT,MPV and APTT have certain clinical value in the diagnosis of sepsis,while PDW and PT have certain clinical significance in the prognosis evaluation of sepsis.