發(fā)布時間：2018-10-05 10:23

【摘要】：目的探討炎性介質(zhì)PCT聯(lián)合凝血指標在ARDS患者預后判斷中的價值,以及炎癥指標與凝血指標之間的相關(guān)性。方法回顧性分析2014年1月至2016年1月期間入住重癥監(jiān)護病房(ICU)患者的臨床資料。納入確診當天、第3天及第7天已行PCT水平及凝血指標(APTT、PT、FIB)水平檢測的急性呼吸窘迫征(ARDS)患者50例。通過采用Spearman法與受試者工作特征(ROC)曲線,分析炎癥指標PCT與凝血指標(APTT、PT、FIB)對患者生存情況的預測能力。結(jié)果死亡組PCT及凝血指標水平明顯高于生存組(p0.05),在第3、7天死亡組患者PCT水平(64.786±13.343,80.372±17.534)明顯高于存活組(5.110±2.789,2.295±0.942),尤其是第7天PCT水平,對預后的預測更有意義;凝血指標在兩組治療前后未發(fā)現(xiàn)太大差異,死亡組的APTT與PT較存活組任何時期都明顯延長,而FIB明顯減少;且PCT聯(lián)合凝血指標預測患者預后的ROC(0.9520)明顯高于單用PCT炎癥因子或凝血指標預測患者預后的ROC(0.9437、0.951、0.9048、0.8859)。結(jié)論升高的PCT水平及異常的凝血指標預示患者預后越差、死亡風險越高,且PCT與凝血指標PT、FIB之間具有相關(guān)性。
[Abstract]:Objective to investigate the prognostic value of inflammatory mediators PCT combined with coagulation in patients with ARDS and the correlation between inflammatory markers and coagulation indexes. Methods the clinical data of (ICU) patients admitted to intensive care unit from January 2014 to January 2016 were analyzed retrospectively. Fifty patients with acute respiratory distress syndrome (ARDS) with acute respiratory distress were examined for PCT and APTT,PT,FIB on the third and seventh day of diagnosis. The predictive ability of inflammation index (PCT) and coagulation index (APTT,PT,FIB) on patients' survival was analyzed by using Spearman method and (ROC) curve. Results the levels of PCT and coagulation in the death group were significantly higher than those in the survival group (p0.05). The PCT level in the death group (64.786 鹵13.343 鹵80.372 鹵17.534) was significantly higher than that in the survival group (5.110 鹵2.789 鹵2.295 鹵0.942) on the 7th day, especially on the 7th day. There was no significant difference in coagulation parameters between the two groups before and after treatment. The APTT and PT in the death group were significantly longer than those in the survival group at any stage, but FIB was significantly decreased. The ROC (0.9520) of PCT combined with coagulation index was significantly higher than that of PCT inflammatory factor or coagulation index alone (0.94370.9041U 0.90480.8859). Conclusion the higher the level of PCT and the abnormal coagulation index, the worse the prognosis and the higher the risk of death. There is a correlation between PCT and PT,FIB.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R563.8

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