河北医科大学学报 ›› 2023, Vol. 44 ›› Issue (9): 1053-1057.doi: 10.3969/j.issn.1007-3205.2023.09.012

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血小板聚集率和血小板黏附率评价脓毒症患儿病情及预后的价值

  

  1. 江苏省淮安市妇幼保健院儿科，江苏 淮安 223001
  • 出版日期:2023-09-25 发布日期:2023-10-12
  • 作者简介:郑聪颖（1985-），女，江西余干人，江苏省淮安市妇幼保健院主治医师，医学学士，从事儿科疾病诊治研究。
  • 基金资助:
    江苏省第五期“333工程”科研项目（BRA2020227）；〖CM（29〗江苏省妇幼健康科研项目（F201940）；淮安市健康卫生科研项目〖CM）〗（HAWJ202117）

Value of platelet aggregation rate and platelet adhesion rate in evaluating the condition and prognosis of children with sepsis

  1. Department of Pediatrics, Huaian Maternal and Child Health Hospital, Jiangsu Province, Huaian 223001, China

  • Online:2023-09-25 Published:2023-10-12

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摘要： 目的  探讨血小板聚集率和血小板黏附率评价脓毒症患儿病情及预后的价值。
方法  选取脓毒症患儿118例为研究对象，收集所有患儿基本资料及可能影响患儿近期预后的生化指标，所有患儿入院后随访28 d统计其生存情况。分析影响脓毒症患儿近期预后的危险因素，分析不同病情严重程度的脓毒症患儿血小板聚集率、血小板黏附率情况，分析血小板聚集率、血小板黏附率预测脓毒症患儿近期预后的价值。
结果  118例脓毒症患儿随访期间死亡20例，生存98例。死亡组儿童器官功能障碍评分2（pediatric logistic organ dysfunction-2，PELOD-2）评分、氧合指数、凝血酶时间（thrombin time，TT）、乳酸均高于生存组，儿童危重病例评分（pediatric critical illness score，PCIS)评分、血小板聚集率、血小板黏附率低于生存组（P＜0.05）。Logistic多因素回归分析结果显示,PELOD-2评分、乳酸、PCIS评分、血小板聚集率、血小板黏附率是影响脓毒症患儿预后的危险因素（P＜0.05）。118例脓毒症患儿中脓毒症未休克患儿69例，脓毒症休克患儿49例，脓毒症休克组的血小板聚集率、血小板黏附率均高于脓毒症未休克组（P＜0.05）。受试者工作特征曲线(receiver operating characteristic curve，ROC)结果显示，血小板聚集率、血小板黏附率及二者联合预测脓毒症患儿近期预后的敏感度分别为75.00%、70.00%、80.00%，特异度分别为74.49%、80.61%、88.78%，曲线下面积分别为0.761、0.768、0.913。
结论  血小板聚集率、血小板黏附率联合预测脓毒症患儿近期预后效能良好。


关键词: 脓毒症, 血小板聚集率, 血小板黏附率, 预后

Abstract: Objective  To explore the value of platelet aggregation rate and platelet adhesion rate in evaluating the condition and prognosis of children with sepsis. 
Methods  A total of 118 children with sepsis were selected as the research subjects. The basic data and biochemical indicators that might affect the short-term prognosis of all children were collected. All children were followed up for 28 days after admission to evaluate their survival.The risk factors affecting the short-term prognosis of children with sepsis were analyzed. The platelet aggregation rate and platelet adhesion rate of children with different severities of sepsis were analyzed. The value of platelet aggregation rate and platelet adhesion rate in predicting the short-term prognosis of children with sepsis was analyzed. 
Results  Of 118 children with sepsis, 20 died and 98 survived during the follow-up period. Pediatric logistic organ dysfunction-2 (PELOD-2) scores, oxygenation index, thrombin time (TT), and lactic acid were higher in the death group than in the survival group, while pediatric critical illness score (PCIS), platelet aggregation rate, and platelet adhesion rate were lower than those in survival group (P＜0.05). Multivariate Logistic regression analysis showed that PELOD-2 score, lactic acid score, PCIS score, platelet aggregation rate and platelet adhesion rate were risk factors affecting the prognosis of children with sepsis (P＜0.05). Among the 118 children with sepsis, 69 had no septic shock and 49 had septic shock. The platelet aggregation rate and platelet adhesion rate in septic shock group were higher than those in non-septic shock group (P＜0.05).The results of receiver operating characteristic (ROC) curve showed that the sensitivity of platelet aggregation rate, platelet adhesion rate and their combination to predict the short-term prognosis of children with sepsis were 75.00%, 70.00% and 80.00%, respectively, the specificity was 74.49%, 80.61%, 88.78%, respectively, and the area under the ROC curve was 0.761, 0.768, 0.913, respectively. 
Conclusion  The combination of platelet aggregation rate and platelet adhesion rate is effective in predicting the short-term prognosis of children with sepsis. 


Key words: sepsis, platelet aggregation rate, platelet adhesion rate, prognosis

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