血常规参数、血浆D-二聚体在败血症诊断及预后应用

目的研究血常规参数、血浆D-二聚体(D-D)在败血症诊断及预后的应用价值。方法选取本院2018年1月至2018年12月败血症患者118例作为观察组,另选取同期非败血症患者120例作为对照组,比较两组血常规参数血小板计数(PLT)、中性粒细胞比例(N%)、白细胞计数(WBC)]及血浆D-D水平,分析血常规参数、血浆D-D诊断价值。根据28 d预后情况将观察组分为生存者(97例)、死亡者(21例)。对比两者血常规参数、血浆D-D水平、序贯器官衰竭估计(SOFA)评分、急性生理与慢性健康Ⅱ(APACHEⅡ)评分,分析血常规参数、血浆D-D与SOFA、APACHEⅡ评分相关性,ROC曲线分析血常规参数、血浆D-D预测预后不良价值。结果观察组PLT低于对照组,N%、WBC、血浆D-D高于对照组(P<0.05);ROC曲线分析,血浆D-D诊断败血症AUC大于PLT、N%、WBC;治疗3 d后生存者PLT高于死亡者,N%、WBC、血浆D-D低于死亡者(P<0.05);治疗3 d后生存者SOFA、APACHEⅡ评分低于死亡者(P<0.05);PLT与SOFA、APACHEⅡ评分呈负相关,N%、WBC、血浆D-D与SOFA、APACHEⅡ评分呈正相关(P<0.05);ROC曲线分析,治疗3 d后血浆D-D预测预后不良的AUC大于PLT、N%、WBC。结论血常规参数、血浆D-D在败血症中呈异常状态,其中PLT、D-D具有良好的诊断价值,且可作为预后不良的重要预测因子,为临床干预提供参考依据。

Application value of blood routine parameters and plasma D-dimer in diagnosis and prognosis of sepsis

Objective To study the application value of blood routine parameters and plasma D⁃dimer(D⁃D)in the diagnosis and prognosis of sepsis.Methods 118 cases of sepsis patients in our hospital from January 2018 to December 2018 were selected as the observation group,and 120 cases of non⁃septic patients in the same period were selected as the control group.The blood routine parametersplatelet count(PLT),neutrophil ratio](N%),white blood cell count(WBC)]and plasma D⁃D level were measured,and the blood routine parameters and the diagnostic value of plasma D⁃D were analyzed.According to the prognosis of 28 days,the observational components were survivors(97 cases)and deceased(21 cases).Compare the blood routine parameters,plasma D⁃D levels,sequential organ failure estimation(SOFA)score,acute physiology and chronic healthⅡ(APACHEⅡ)score,we analyzed the correlation between blood routine parameters,plasma D⁃D and SOFA,APACHEⅡscore,ROC curve analysis Blood routine parameters and plasma D⁃D predict poor prognostic value.Results The PLT in the observation group was lower than that in the control group,and N%,WBC,and plasma D⁃D were higher than those in the control group(P<0.05).According to ROC curve analysis,the AUC of plasma D⁃D in the diagnosis of sepsis was greater than PLT,N%,and WBC.The PLT was higher in survivors after 3 days of treatment.N%,WBC,and plasma D⁃D were lower than those who died(P<0.05).SOFA and APACHEⅡscores were lower in survivors after 3 days of treatment(P<0.05).PLT was negatively correlated with SOFA and APACHEⅡscores N%,WBC,and plasma D⁃D were positively correlated with SOFA and APACHEⅡscores(P<0.05).ROC curve analysis showed that the AUC with poor predictive prognosis of plasma D⁃D after 3 days of treatment was greater than PLT,N%,and WBC.Conclusion Blood routine parameters and plasma D⁃D showed abnormal status in sepsis.Among them,PLT and D⁃D have good diagnostic value,and can be used as important predictors of poor prognosis,providing reference for clinical intervention.