全身炎症反应综合征患者凝血功能的研究

目的 研究全身炎症反应综合征(SIRS)患者凝血功能的变化,为采用抗凝治疗提供理论基础.方法 将入住重症监护病房的患者分为SIRS组30例,非SIRS组25例,另选取健康对照组30例,分别检测血小板计数(PLT)、血浆凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(DD)等与凝血功能有关的实验室指标.结果 SIRS组中PT、TT、APTT、DD分别为(16.48±1.57)、(22.67±1.48)、(43.56±4.33)s与(2.25±0.18)mg/L]均高于非SIRS组分别为(12.83 ±1.23)、(17.05±1.97)、(33.34±2.38)s与(0.58 ±0.15)mg/L]及健康对照组分别为(12.04±0.98)、(16.88±1.37)、(29.84±1.98)s与(0.43 ±0.11)mg/L](P均<0.05),PLT、FIB分别为(110.69±50.23)×109/L、(2.05±0.33)g/L]均低于非SIRS组分别为(180.58±45.70)×109/L、(3.54±0.29)g/L]及健康对照组分别为(204.95±46.83)×109/L、(3.78±0.54)g/L](P均<0.05).结论 SIRS患者存在凝血功能紊乱,其主要表现为凝血激活,促凝物质增加、抗凝物质减少、纤溶系统受抑制,凝血系统异常可能在SIRS的发生、发展过程中起重要作用.

Study of coagulation function in patients of systemic inflammatory response syndrome

Objective To study the change of coagulation function in the patients of systemic inflammatory response syndrome (SIRS) , and to provide evidences on anticoagulation therapy. Methods All of the patients in ICU were divided into two groups: SIRS (30 patients) and non-SIRS(25 patients). Thirty healthy adults were recruited as controls. Prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT) , fibrinogen(FIB),levels of platelet (PLT) and D-dimer were measured in all patients and healthy adults. Results The levels of PT, APTT,TT.DD in the SIRS group((16.48 ± 1. 57) s, (22. 67 ± 1. 48) s, (43. 56 ±4.33)s and (2.25 ±0.18)mg/L respectively) were significantly higher than those in the non-SIRS group((12. 83 ± 1.23)s, (17. 05 ±1. 97)s,(33. 34 ±2. 38)s and(0. 58 ±0. 15)mg/L respectively)and the control group ((12. 04 ±0. 98) s,(16. 88 ±1. 37)s,(29. 84 ±1.98)s and (0.43 ±0. 11)mg/L respectively) (P <0. 05). The levels of PLT,FIB in the SIRS group((110. 69 ±50. 23) × 109/L and(2. 05 ±0. 33) g/L, respectively) were significantly lower than those in the non-SIRS group((180. 58 ±45. 70) × 109/L and(3. 54 ±0. 29)g/L,respectively)and the control group ((204. 95 ± 46. 83) × 109/L and (3. 78 ± 0. 54) g/L, respectively) (P < 0. 05). Conclusions The dysfunction of coagulation exits in SIRS. Coagulation system abnormity might play an important role in the development of SIRS.