目的 研究前白蛋白( PA) 、D-二聚體( DD) 及Plt 動態(tài)變化與重癥膿毒癥患者病情嚴重度及預(yù)后的關(guān)系。方法 測定198 例重癥膿毒癥患者入組第1 d、第5 d, 以及出院或死亡前最后一次的PA、DD、Plt、APACHEⅡ 評分, 按預(yù)后將患者分為死亡組及存活組, 進行動態(tài)觀察, 并做APACHEⅡ評分和PA、DD 及PLT 水平動態(tài)變化的相關(guān)性分析。結(jié)果 死亡組與存活組入組第1 dPA、DD 及Plt 比較均無顯著差異, 死亡組第5 d 及最后一次DD 水平明顯高于存活組( P lt;0. 05) , PA和Plt 明顯低于存活組( P lt;0. 01) 。DD 與APACHEⅡ評分呈正相關(guān), PA、Plt 與APACHEⅡ評分呈負相關(guān)。結(jié)論 DD與膿毒癥患者病情嚴重程度呈正相關(guān), PA 與病情嚴重程度呈負相關(guān)。DD 持續(xù)高水平與PA、Plt 持續(xù)低水平提示病情危重, 預(yù)后不良, 所以聯(lián)合動態(tài)觀察PA、DD 和Plt 對判斷病情危重度及預(yù)后有一定的評估價值。
引用本文： 楊鈞,奚晶晶. 前白蛋白、D-二聚體及血小板動態(tài)變化評估重癥膿毒癥患者病情嚴重度的臨床分析. 中國呼吸與危重監(jiān)護雜志, 2009, 09(3): 292-293. doi: 復(fù)制
| 1. | Dellinger RP, Carlet JM, Masur H, et al. Surviving Sepsis Campaign guideline for treatment of severe sepsis and septic shock. Crit Care Med, 2004, 32, 3: 858-873. |
| 2. | Stoica GS, Cohen RI, Rossoff LJ. Adult Still’s disease and respiratory failure in a 74 year old woman. Postgrad Med J, 2002, 78: 97-98. |
| 3. | Pinilla JC, Hayes P, Laverty W, et al. The C-reactive protein to prealbumin ratio correlates with the severity of multiple organ dysfunction. Surgery, 1998, 124: 799-805. |
| 4. | ten Cate H, Timmerman JJ, Levi M. The pathophysiology of disseminated intravascular coagulation. Thromb Haemost, 1999, 82 :713-717. |
| 5. | Brun-Buisson C, Doyon F, Carlet J, et al. Incidence, risk factors, and outcome of severe sepsis and septic shock in adults. A multicenter prospective study in intensive care units. French ICU Group for Severe Sepsis. JAMA, 1995, 274: 968-974. |
| 6. | 華川. 應(yīng)激狀態(tài)下影響血小板聚集功能的相關(guān)因素. 華北國防醫(yī)藥, 2006, 18: 279 -281. |
| 7. | Gando S, Nanzaki S, Sasaki S, et al. Activation of t he ex2 t rinsic coagulation pat hway in patient s with severe sepsis and septic shock.Crit Care Med, 1998, 12: 2005-2009. |
- 1. Dellinger RP, Carlet JM, Masur H, et al. Surviving Sepsis Campaign guideline for treatment of severe sepsis and septic shock. Crit Care Med, 2004, 32, 3: 858-873.
- 2. Stoica GS, Cohen RI, Rossoff LJ. Adult Still’s disease and respiratory failure in a 74 year old woman. Postgrad Med J, 2002, 78: 97-98.
- 3. Pinilla JC, Hayes P, Laverty W, et al. The C-reactive protein to prealbumin ratio correlates with the severity of multiple organ dysfunction. Surgery, 1998, 124: 799-805.
- 4. ten Cate H, Timmerman JJ, Levi M. The pathophysiology of disseminated intravascular coagulation. Thromb Haemost, 1999, 82 :713-717.
- 5. Brun-Buisson C, Doyon F, Carlet J, et al. Incidence, risk factors, and outcome of severe sepsis and septic shock in adults. A multicenter prospective study in intensive care units. French ICU Group for Severe Sepsis. JAMA, 1995, 274: 968-974.
- 6. 華川. 應(yīng)激狀態(tài)下影響血小板聚集功能的相關(guān)因素. 華北國防醫(yī)藥, 2006, 18: 279 -281.
- 7. Gando S, Nanzaki S, Sasaki S, et al. Activation of t he ex2 t rinsic coagulation pat hway in patient s with severe sepsis and septic shock.Crit Care Med, 1998, 12: 2005-2009.