老年社区获得性肺炎并发呼吸衰竭患者血小板及凝血功能变化及意义

目的 探讨老年社区获得性肺炎并发呼吸衰竭患者血小板及凝血功能变化情况,以便为临床诊治提供指导.方法 对2017年3月1日-2019年3月1日某院CAP患者300例进行回顾性研究,并根据是否合并呼吸衰竭分为呼吸衰竭组(n=54)与非呼吸衰竭组(n=246),比较两组、呼吸衰竭组老年不同社区获得性肺炎CURB-65评分、急...

Changes and Significance of Platelet and Coagulation Function in Elderly Patients with Community-Acquired Pneumonia Complicated With Respiratory Failure

Objective To investigate-the changes of platelet and coagulation’function in elderly-patients with community-acquired pneumonia complicated by respiratory failure in order to provide clinical data support.Methods A retrospective study was conducted on 300 CAP patients in a hospital from March 1,2017 to March 1,2019.According to whether they are combined with respiratory failure,they are divided into respiratory failure group(n=54)and non-respiratory failure group(n=246).Comparing the platelet and coagulation function indexes(mean platelet volume,platelet,D-dimer,fibrinogen)of elderly patients with different community-acquired pneumonia CURB-65 scores,acute physiology and chronic health statusⅡscores and patients with different prognosis in the two groups and respiratory failure group,and analyzing the correlation between platelet and coagulation function indexes of patients with CAP complicated by respiratory failure and age,CURB-65,APACHEⅡscore,and their predictive value for prognosis.Results The MPV(10.94±1.40)fL,(9.37±1.35)fL,DD(10.39±2.37)mg/L and(8.61±2.14)mg/L of the elderly,middle-aged and young adults in the respiratory failure group were higher than those in the non-respiratory failure group(8.47±1.32)fL,(2.47±0.65)mg/L,PLT(175.47±37.48)×10⁹/L,(206.20±41.25)×10⁹/L,FIB(2.89±0.75)g/L,(3.86±0.82)g/L were lower than non-respiratory failure group(275.37±52.49)×10⁹/L,(4.85±1.14)g/L,the difference was statistically significant(P<0.05);MPV(r=0.357)and DD(r=0.416)in patients with CAP complicated by respiratory failure were positively correlated with age,while PLT(r=-0.382)and FIB(r=-0.405)were negatively correlated with age(P<0.05);the MPV(r=0.485,0.606)and DD(r=0.581,0.752)levels of elderly CAP patients with respiratory failure were positively correlated with CURB-65 and APACHEⅡscores,PLT(r=-0.759,-0.721),FIB(r=-0.743,-0.678)were negatively correlated with CURB-65 and APACHEⅡscores(P<0.05);the combined prediction of MPV,DD,PLT,and FIB in elderly patients with CAP complicated by respiratory failure had the largest prognostic area under the curve(AUC),which was 0.876,with a sensitivity of 80.00%and a specificity of 82.35%.Conclusion There are abnormalities of platelet and coagulation function in elderly patients with CAP complicated with respiratory failure.The combination of the two can be used as an auxiliary indicator of the severity of the disease and the prognosis.