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[1]钟林翠,宋景春,姜峻,等.血小板聚集率在评价脓毒症患者血小板功能及预后中的价值[J].医学研究与战创伤救治(原医学研究生学报),2020,22(3):249-253.[doi:10.3969/j.issn.1672-271X.2020.03.006]
　ZHONG Lin-cui,SONG Jing-chun,JIANG Jun,et al.Clinical study on platelet aggregation to evaluate platelet function and prognosis in patients with sepsis[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2020,22(3):249-253.[doi:10.3969/j.issn.1672-271X.2020.03.006]
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血小板聚集率在评价脓毒症患者血小板功能及预后中的价值()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第22卷
期数:
2020年3期
页码:
249-253
栏目:
临床研究
出版日期:
2020-05-15

文章信息/Info

Title:
Clinical study on platelet aggregation to evaluate platelet function and prognosis in patients with sepsis
作者:
钟林翠; 宋景春; 姜峻; 胡艳晶; 何龙平; 曾庆波; 林青伟
作者单位：330002南昌，解放军联勤保障部队第九○八医院重症医学科（钟林翠、宋景春、姜峻、胡艳晶、何龙平、曾庆波、林青伟）
Author(s):
ZHONG Lin-cui;  SONG Jing-chun;  JIANG Jun; HU Yan-jing;  HE Long-ping;  ZENG Qing-bo;  LIN Qing-wei
(Intensive Care Unit, the 908th Hospital of the Joint Logistics Support Force，PLA, Nanchang 330002, Jiangxi, China)
关键词:
脓毒症; 血栓弹力图; 血小板聚集率; 花生四烯酸; 二磷酸腺苷
Keywords:
sepsis;  thromboelastography;  platelet aggregation;  arachidonic acid;  adenosine diphosphate
分类号:
R459.7
DOI:
10.3969/j.issn.1672-271X.2020.03.006
文献标志码:
A
摘要:
目的探讨花生四烯酸(AA)和二磷酸腺苷（ADP）血小板聚集率在评价脓毒症患者血小板功能中的临床价值。方法回顾性分析2017年7月至2019年2月解放军联勤保障部队第九○八医院重症医学科收治的62例脓毒症患者临床资料。根据60 d生存情况分为生存组（n=51）与死亡组（n=11），比较患者入科2 h内的血小板(PLT)计数、血块最大强度(MA)值、AA和ADP血小板聚集率等指标。结果与生存组患者AA血小板聚集率[75.5（64.5~82.5）%]和ADP血小板聚集率[71.5（59.3~77.2）%]比较，死亡组[51.9(33.6~64.8)%、51.2(32.5~68.5)%]均显著下降（P<0.05）；而MA值和PLT计数差异无统计学意义（P>0.05）。PLT计数与AA、ADP血小板聚集率和MA的相关系数依次为0.403、0.477和0.580（P<0.01），MA值与ADP血小板聚集率的相关系数为0.310（P＜0.05）；Logistic回归结果显示ADP血小板聚集率是脓毒症预后的保护因素（P<0.01）；ADP血小板聚集率预测脓毒症生存的曲线下面积为0.734（95%CI:0.545~0.924,P=0.015）；生存分析显示ADP血小板聚集率<63.1%患者的死亡风险是ADP血小板聚集率≥63.1%患者的5.2倍（95%CI:1.62~19.64）差异有统计学意义（P<0.01）。 结论ADP血小板聚集率<63.1%的脓毒症患者血小板聚集功能明显障碍，且死亡率显著升高。
Abstract:
ObjectiveTo assess the clinical value of changes of platelet aggregation induced by arachidonic acid (AA) and adenosine diphosphate (ADP) and evaluate platelet function in patients with sepsis.MethodsThe clinical data were obtained from patients with sepsis at the intensive care unit,908th Hospital of Chinese PLA Joint Logistic Support Force from July 2017 to February 2019. According to the 60d living situation, the patients were divided into survival group and death group. The platelet (PLT) counts,maximum amplitude (MA) values,AA-induced and ADP-induced platelet aggregation were collected and compared between the two groups.ResultsCompared to AA-induced platelet aggregation [75.5(64.5-82.5)%] and ADP-induced platelet aggregation[71.5(59.3-77.2)%] in the survival group, the rates of the death group [51.9(33.6-64.8)%,51.2(32.5-68.5)%] decreased significantly (P<0.05). However, there was no significant difference between the MA value and PLT count. The correlation coefficients between PLT count with AA-induced platelet aggregation rate, ADP-induced platelet aggregation rate and MA value were 0.403, 0.477 and 0.580, respectively(P<0.01). Correlation coefficients between MA value with ADP-induced platelet aggregationrate was 0.310(P<0.05), respectively. Logistic regression analysis showed that ADP-induced platelet aggregation was a protective factor for sepsis. The area under the receiver operating characteristic curves of ADP-induced platelet aggregation predicting sepsis survival was 0.734 (95%CI: 0.545-0.924,P=0.015）. Kaplan-Meier analysis demonstrated that the death risk of the patients with ADP-induced platelet aggregation rate<63.1% was 5.2 times(95%CI:1.62-19.64) (P<0.01) of those with ADP-induced platelet aggregation rate≥63.1%.ConclusionSepsis patients with ADP aggregation rate <63.1% showed significantly impaired platelet aggregation function and the mortality was considerably higher.

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备注/Memo

备注/Memo:
基金项目：江西省教育厅创新课题（YC2018-S274）；江西省卫健委科技计划(20204820)
更新日期/Last Update: 2020-05-15