TEG联合凝血功能对重症肺部感染患者病情程度及预后的评估价值

Evaluation value of TEG combined with coagulation function in judging the condition and prognosis of patients with severe pulmonary infection

目的探讨血栓弹力图(TEG)联合凝血功能检测对重症肺部感染病情程度以及预后的评估价值。方法前瞻性纳入118例重症肺部感染患者,根据急性生理与慢性健康评分Ⅱ(APACHEⅡ)评分结果将其分为非重症组38例、危重症组52例、极危重症组28例;根据临床结局分为生存组85例和死亡组33例。比较各组凝血功能指标及TEG指标,分析其评估价值。结果与非重症组比较,危重症组和极危重症组凝血酶原时间(PT)、活化部分凝血活酶原时间(APTT)延长,D-二聚体(D-D)水平、K值、R值升高,血小板计数(PLT)、MA值和α角降低,且极危重症组较危重症组更为显著(P<0.05)。PT、APTT、D-D、K值和R值,死亡组高于生存组,PLT、MA值与α角,死亡组低于生存组(P<0.05)。AUC比较,联合检测指标>TEG指标>凝血功能指标(P<0.05)。结论TEG和凝血功能联合检测对重症肺部感染患者病情程度及预后评估价值较好。

Aim To explore the evaluation value of TEG combined with coagulation function test in judging the condition and prognosis of severe pulmonary infection.Methods 118 patients with severe pulmonary infection were prospectively enrolled and divided into non-severe group,critical group and extremely critical group according to APACHEⅡscore.The indexes of routine coagulation function and thromboelastogram(TEG)were detected respectively,and their evaluation values were analyzed.Results Compared with the levels of PT,APTT,D-D,K and R,the level of PLT,MA andαangle in the critically ill group were higher than those in the non-critical group and the critically ill group,while those in the critically ill group were lower than those in the non-critical group and the critically ill group(P<0.05).The levels of PT and APTT in the death group were higher than those in the survival group,while the levels of D-D,MA andαwere higher in the survival group.The levels of PLT,K and R were lower in the death group(P<0.05).By comparing AUC,it was revealed that combined detection>TEG index>coagulation function index(P<0.05).Conclusion TEG and coagulation function have certain evaluation value for the condition judgment and prognosis of patients with severe pulmonary infection.