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目的:探讨脓毒症患者血小板平均体积与疾病严重程度及预后的关系。方法:选取115例脓毒症患者,根据28d死亡情况分为死亡组和生存组2组,观察入院24h、48h、72hPLT计数和血小板平均体积(MPV)的变化,记录年龄、性别、病灶部位、SOFA评分等一般资料,并比较2组脓毒症患者入院24h、48h、72hPLT、MPV的差异,以及MPV与疾病严重程度的相关性,并采用受试者工作特征曲线(ROC)分析不同时期MPV对脓毒症患者死亡预后的判断能力。结果:生存组和死亡组入院24h、48h、72h后PLT计数之比分别为:(176.06±103.06)×109/L-1∶(155.19±116.34)×109/L-1、(152.42±86.47)×109/L-1∶(118.51±89.28)×109/L-1、(157.29±94.76)×109/L-1∶(103.00±88.26)×109/L-1,MPV之比分别为(10.96±1.22)fl∶(11.59±1.21)fl、(11.41±1.11)fl∶(11.57±0.86)fl、(11.28±1.10)fl∶(12.21±0.98)fl。死亡组PLT随入院时间延长逐渐下降,而生存组在入院48h下降,入院72h轻度升高;生存组MPV在入院48h上升明显,随后下降,而死亡组MPV在入院48h轻度下降而后明显上升;2组比较入院48h MPV差异有统计学意义(P<0.05);脓毒症患者PLT计数与预后(死亡)负相关,MPV与预后正相关,尤其入院72h MPV显著;入院24h、48h、72h MPV的ROC曲线下面积分别为0.646、0.555、0.736,均显著高于入院24h、48h、72hPLT计数的ROC曲线下面积(分别为0.417,0.361,0.267),入院72h的MPV判断死亡预后的敏感度及特异度分别为53.50%和84.70%。结论:脓毒症患者MPV变化与脓毒症疾病严重程度相关,入院72h的MPV对脓毒症患者预后有较好的预测价值。
Objective: To investigate the relationship between the average platelet volume and the severity and prognosis of patients with sepsis. Methods: One hundred and fifteen patients with sepsis were divided into death group and survival group according to the death of 28 days. The changes of PLT count and platelet volume (MPV) at admission were observed at 24h, 48h, 72h. The age, sex, SOFA score and other general information, and compared the difference of PLT, MPV at 24h, 48h, 72h after admission and the correlation between MPV and the severity of sepsis in two groups of sepsis patients. The receiver operating characteristic curve (ROC) Judgment on the prognosis of death in patients with sepsis. Results: The PLT counts in survival group and death group were (176.06 ± 103.06) × 109 / L-1 (155.19 ± 116.34) × 109 / L-1, (152.42 ± 86.47) The ratio of MPV was (10.96) × 109 / L-1 (118.51 ± 89.28) × 109 / L-1 and (157.29 ± 94.76) × 109 / L-1 (103.00 ± 88.26) × 109 / ± 1.22) fl: (11.59 ± 1.21) fl, (11.41 ± 1.11) fl: (11.57 ± 0.86) fl, (11.28 ± 1.10) fl: (12.21 ± 0.98) fl. The PLT of death group decreased gradually with the prolongation of hospitalization, while the survival group decreased 48h after admission and increased slightly at 72h after admission. The MPV of survival group increased significantly 48h after admission, then decreased, while MPV of death group decreased slightly at 48h after admission, (P <0.05). The PLT count was negatively correlated with prognosis (death) in sepsis patients. MPV was positively correlated with prognosis, especially at 72h after admission. There was no significant difference between the two groups at admission of 24h, 48h, 72h The areas under ROC curve of MPV were 0.646,0.555,0.736 respectively, which were significantly higher than those under ROC curve (0.417,0.361,0.267, respectively) at 24 h, 48 h and 72 h after admission. The sensitivity of MPV to determine the prognosis of death at 72 h And specificity were 53.50% and 84.70% respectively. CONCLUSIONS: The changes of MPV in septic patients are related to the severity of sepsis. The 72-h MPV admitted to hospital will have a better predictive value for the prognosis of patients with sepsis.