全身炎症反应综合征患者凝血功能的研究

目的对全身炎症反应综合征(SIRS)患者凝血功能的变化进行研究,以期为临床诊治提供新思路.方法将入住急诊监护病房的患者分为SIRS组50例和非SIRS组30例,另选健康对照组30例,分别测其血小板计数(PLT)、D-二聚体(DD)、凝血酶原时间(PT)、凝血酶时间(IT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FBG)、血栓调节蛋白(TM)、蛋白C(PC)、蛋白S(PS)、组织纤溶酶原激活物(TPA)、纤溶酶原激活物抑制物(PAI-1)11项与凝血功能有关的实验室指标.结果 SIRS组中TT、APTT、PT、DD、TM和PAI-1均高于非SIRS组及对照组(P＜0.05);PC、PS、TPA、PLT、FBG均低于非SIRS组及对照组(P＜0.05).结论①SIRS时存在着凝血功能紊乱.②SIRS时凝血系统功能紊乱主要特征表现为各种促凝物质增加,机体抗凝物质减少,纤溶系统被抑制,而纤溶系统抑制在SIRS发生、发展过程中可能起到更加重要的作用.

Study of coagulation dysfunction in the patients with SIRS

Objective In order to find a new diagnostic and treating way for clinical doctors, we studied the effects of coagulation dysfunctions on the patients with development of SIRS. Methods All the patients were divided into 2 groups: SIRS and non- SIRS according to the criteria for the selection of SIRS. The SIRS group included 50 patients and the non- SIRS group 30 patients.Control group included 30 healthy adults. Levels of platelet (PLT), D-dimer, protein C(PC), protein S(PS), thrombomodulin(TM), tissue plasminogen activator(TPA), plasminogen-activator inhibitor(PAI-1), prothrombin time(PT), thrombin time(TT), activated partial thromboplastin time(APTT), and fibrinogen(FBG) were measured in all the patients and healthy adults. Results Levels of TT, APTT, PT, D-dimer, TM, PAI-1 were significantly higher in SIRS group than those in non-SIRS and control group (P<0.05). Levels of PC, PS, TPA, PLT, FBG were significantly lower in SIRS group than those in non-SIRS and control group (P<0.05). Conclusions There are the dysfunctions of coagulation in the patients with SIRS. Fibrinolytic system plays an important role in the development of SIRS.