脓毒性休克合并弥散性血管内凝血患者血小板最大聚集率及乳酸/白蛋白比值的变化及意义

Changes and Significance of Maximum Platelet Aggregation Rate and Lactate/Albumin Ratio in Patients with Septic Shock Complicated by Disseminated Intravascular Coagulation

目的探究脓毒性休克合并弥散性血管内凝血(DIC)患者血小板最大聚集率、乳酸/白蛋白比值的变化及意义。方法选取安阳市人民医院2021年10月至2022年10月收治的102例脓毒性休克合并DIC患者作为研究组。另选取同期106例为脓毒性休克患者作为对照组。受试者均行血小板最大聚集率、乳酸/白蛋白比值检测并进行对比。评估血小板最大聚集率、乳酸/白蛋白比值联合检测对脓毒性休克患者合并DIC的诊断价值。同时分析影响脓毒性休克患者合并DIC的影响因素。结果研究组乳酸/白蛋白比值(0.50±0.05)高于对照组(0.15±0.02),差异具有统计学意义(P<0.05),研究组血小板最大聚集率[(57.97±8.18)%]低于[(73.40±10.96)%],差异具有统计学意义(P<0.05)。两组患者性别、年龄、吸烟史、饮酒史、血钠、血钾、血小板计数、血液净化情况、纤维蛋白原降解产物(FDP)、血小板计数、肝功能损伤、肾功能损伤、气管切开、血钠紊乱、平均动脉压、白细胞计数对比差异无统计学意义(P>0.05)。以脓毒性休克患者合并DIC为因变量,血小板最大聚集率、乳酸/白蛋白比值为自变量,二元Logistic多因素分析结果显示,乳酸/白蛋白比值为脓毒性休克患者合并DIC的危险因素,血小板最大聚集率为脓毒性休克患者合并DIC的保护因素,差异具有统计学意义(P<0.05)。结论血小板最大聚集率、乳酸/白蛋白比值与脓毒性休克患者合并DIC相关,可加强检测脓毒性休克合并DIC患者血小板最大聚集率、乳酸/白蛋白比值。

Objective To investigate the changes and significance of the maximum platelet aggregation rate and lactate/albumin ratio in patients with septic shock complicated by disseminated intravascular coagulation(DIC).Methods A total of 102 patients with septic shock complicated by DIC who were treated at Anyang People's Hospital from October 2021 to October 2022 were selected as the study group.Another 106 patients with septic shock during the same period were selected as the control group.All subjects underwent testing for maximum platelet aggregation rate and lactate/albumin ratio.The diagnostic value of combined detection of these parameters for septic shock complicated by DIC was evaluated.Factors influencing septic shock patients complicated by DIC were also analyzed.Results The lactate/albumin ratio in the study group(0.50±0.05)was higher than in the control group(0.15±0.02),with statistically significant differences(P<0.05).The maximum platelet aggregation rate in the study group[(57.97±8.18)%]was lower than in the control group[(73.40±10.96)%],with statistically significant differences(P<0.05).There were no statistically significant differences in gender,age,smoking history,drinking history,blood sodium,blood potassium,platelet count,blood purification,fibrinogen degradation product(FDP),platelet count,liver function damage,renal function damage,tracheostomy,sodium disorder,mean arterial pressure,and white blood cell count between the two groups(P>0.05).Binary logistic multivariate analysis showed that the lactate/albumin ratio was a risk factor,and the maximum platelet aggregation rate was a protective factor for septic shock patients complicated by DIC(P<0.05).Conclusion The maximum platelet aggregation rate and lactate/albumin ratio are associated with septic shock complicated by DIC.Strengthening the detection of these parameters in such patients can be valuable.