血小板数量对严重急性呼吸综合征患者预后的影响

为探讨严重急性呼吸综合征(SARS)患者血小板数量与病情严重程度和预后的关系,对我院2003年5至6月收治的133例临床确诊的SARS患者的一般情况进行回顾性调查研究,比较血小板下降组与血小板正常组2组之间在病情轻重、年龄、最重胸片病变面积、出院时胸片正常率、感染、入住ICU、死亡、白细胞、淋巴细胞数量异常的发生率及继发肝功能异常、乳酸脱氢酶(LDH)、肌酸磷酸激酶(CPK)、血糖异常等的发生率之间的差异。结果血小板下降组(<100×109/L)重症患者和年龄>50岁患者所占的比例、总的病程、平均年龄明显高于血小板正常组(P<0.01);血小板下降组患者胸片严重程度、感染的发生率、入住ICU和死亡患者所占比例、病程中出现WBC>10×109/L或并发肝功能异常、LDH、CPK、电解质异常和高血糖的发生率明显高于血小板正常组(P<0.01)。血小板正常组出院时胸片正常的比例明显大于血小板下降组(P<0.01)。以血小板<150×109/L为标准再次进行分组,在血小板下降组和非下降组之间上述指标仍有显著差异(P<0.01)。提示血小板数量低的患者病情严重程度和生化指标异常等的发生率明显高于血小板正常组,预后差,病死率高。血小板的数量及其动态变化对SARS患者的病情严重程度、预后及转归有很好的提示作用。

Effects of Platelete Counts on Prognosis in Patients with Severe Acute Respiratory Syndrome

The objective was to investigate the relationship between platelet(plt)counts and prognosis in patients with severe acute respiratory syndrome(SARS).Parameters in 133 SARS patients admitted to Xuanwu Hospital in Beijing from May 2003 to June 2003 were analyzed retrospectively.Results:The inortality in the cases being treated in ICU remarkably increased in thrombocytopenia group,compared with those in normal group.The level of high bloodglucose and abnormal LDH、CPK、WBC and lymphopenia in thrombocytopenia group is much higher than that of normal platelet group(P< 0.01).The ratio of severe type patients and their average age in thrombocytopenia patients were much higher than that in the other group(P<0.01).These diferences were observed in platelet counts<150×10⁹/L group.Platelet counts may provide us with a good criteria for detecting disease severity and prognosis in patients with SARS.The changes of platelet counts in patients with SARS is an important predictor to prognosis.We should not only pay attention to patients whose platelet counts are lower than 100×10⁹/L,but also pay much attention to patients whose platelet counts are lower than 150×10⁹/L.