【摘要】 目的:研究血小板计数及其动态变化对老年危重病患者预后的影响。方法:将急诊193例患者,入院时进行APACHEⅡ评分及入院第1、3、7、10天进行血小板计数检测。根据APACHEⅡ评分值将患者分为3组,Ⅰ组(<15分)、Ⅱ组(15～20分)、Ⅲ组(>20分);分析3组患者血小板计数及其动态变化和预后;并回顾性将Ⅱ组、Ⅲ组患者分为死亡组62例和存活组63例,比较两组的APACHEⅡ评分和血小板水平。结果:Ⅰ组血小板水平明显高于Ⅱ组、Ⅲ组(P<0.01),Ⅲ组血小板水平明显低于Ⅱ组(P<0.05);Ⅰ组死亡率明显低于Ⅱ组、Ⅲ组(P<0.01),Ⅲ组死亡率明显高于Ⅱ组(P<0.05)。死亡组与存活组入院时APACHEⅡ评分均较高,治疗7天和10天后,APACHEⅡ评分,存活组下降至10分以下,而死亡组上升至20分以上,死亡组明显增高(P<0.01);入院时存活组和死亡组患者血小板计数均低于正常生理范围,两组间差异无显著性,但在治疗后7天和10天,死亡组患者血小板计数再度进行性下降,与存活组间差异存在显著性(P均<0.01)。结论:血小板减少及其动态改变能较正确、敏感地反映危重病患者的病情和预后,其检查快速、简单、易行,在临床上有较大的实用价值。更多还原

【Abstract】 Objective:To study the effects of platelet count and its dynamic change on prognosis of elder erifical patients.Methods:193elder critical patients were enrolled in this study,and allocated into groupⅠ(<15scores),groupⅡ(15～20scores)and groupⅢ(>20scores)according to APACHEⅡscore.The platelet count was performed immediately after hospitalization,3,7and10days later.Platelet levels and prognosis were analysed.All the patients in the groupⅡandⅢwere divided into two groups,namely survival group(n=63)and non-survival group(n=62)according to the the disease conversion and the APACHEⅡscore,and platelet levels were compared between the two groups.Results:The platelet level in the groupⅠwas significantly higher than that in groupⅡandⅢ(P<0.01),and that in groupⅢwas markedly lower than that in groupⅡ(P<0.05).The death rate in the groupⅠwas significantly lower than that in groupⅡandⅢ(P<0.05),and that in groupⅢwas markedly higher than that in groupⅡ(P<0.05).The APACHEⅡscore in both survival group and non-survival group was higher,however,it increased above20points in the non-survival group and lovered below10points in survival group7and10days after treatment,with a significant difference between the two groups(P<0.01).Platelet was slightly lower in both groups immediatly after hospitalizaˉtion,without significant differenct between two groups.After7and10days of treatment,platelet count increased to the normal range in the survival group and dropped progressively in non-survival group,with significant difference between them(all P<0.01).Conclusion:Refractory thromˉbocytopenia is sensitive indication of poor prognosis and severity of elder critical patients.更多还原