早期联合检测血小板膜糖蛋白及血小板参数对脓毒症患者的临床意义
Early joint detection of platelet membrane glycoproteins and platelet parameters in patients with sepsis clinical significance

喻秋平,杨蕙文,叶兴文,李力,刘松.早期联合检测血小板膜糖蛋白及血小板参数对脓毒症患者的临床意义[J].内科急危重症杂志,2015,21(5):

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英文关键词:Early Platelet membrane glycoproteins Platelet parameters sepsis

基金项目:江西省卫生厅科技项目课题(编号：20157096)

作者	单位	E-mail
喻秋平	九江学院附属医院ICU	yu_88@sohu.com
杨蕙文	九江学院附属医院ICU
叶兴文	九江学院附属医院ICU
李力	九江学院附属医院ICU
刘松	九江学院附属医院ICU

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中文摘要:

摘要目的：探讨早期联合检测血小板膜糖蛋白表达水平及血小板参数对脓毒血症患者的临床意义。方法：选取2014年1月-2014年12月我院收治的40例脓毒症患者，根据APACHE II评分分为1组(APACHEII评分<10分)、2组(APACHEII评分10-19分)和3组(APACHEII评分＞20分)，所有患者均在确诊24h内采用全自动血细胞仪检测血小板计数（PLT）、大血小板比率（P-LCR）、血小板平均体积（MPV）、血小板分布宽度(PDW)；采用流式细胞仪检测血小板膜糖蛋白CD62P、CD63的表达水平。结果：1.随着APACHEII评分升高，患者PLT显著下降，P-LCR、MPV、PDW均显著上升，差异有统计学意义（P<0.05）；2. 随着APACHEII评分升高，CD62P、CD63表达均上调，差异有统计学意义（P<0.05）。3. Pearson 相关性分析显示：随着PLT的下降，血小板MPV、PDW 、P-LCR均逐渐上升，血小板MPV、PDW 、P-LCR与PLT呈高度负相关系（r=-0.442、-0.395、-0.472，P<0.01），PLT与APACHEII评分呈高度负相关性（r=-0.602，P<0.01）；血小板膜糖蛋白CD62P、CD63表达水平与APACHEII评分呈高度正相关性（r=0.603、0.619，P<0.01）；血小板MPV与CD62P、CD63表达水平均呈正相关（r=0.382、0.310，P<0.05），血小板P-LCR 、PLT、PDW 与CD62P、CD63表达水平之间无明显相关性（P>0.05）。结论：脓毒症患者早期体内存在血小板高激活状态，脓毒症患者血小板膜糖蛋白CD62P、CD63及血小板参数可初步判定脓毒症患者病情的变化。

英文摘要:

Abstract　Objective: To explore the early joint detection of platelet membrane glycoprotein expression level and platelet parameters in patients with sepsis clinical significance. methods: Selection in January 2014 - December 2014, our hospital of 40 patients with sepsis, according to the APACHE II score divided into 1 group (APACHEII score < 10), two groups (APACHEII score 10 to 19 points) and 3 groups (APACHEII score > 20), all patients within 24 h of diagnosis using automatic blood cell analyzer detecting platelet parameters PLT, P - the LCR, MPV and PDW; Using flow cytometry instrument to detect the expression of platelet membrane glycoprotein CD62P and CD63 level.. Results: 1. With the increase of APACHEII scores, patients with platelet count PLT decreased significantly, P - the LCR, MPV and PDW were significantly increased, the difference was statistically significant (P < 0.05); 2. With the increase of APACHEII scores, expression of CD62P and CD63 were raised, the difference was statistically significant (P < 0.05). 3. Pearson correlation analysis showed that: With reduced platelet count PLT, MPV and PDW platelet, P - the LCR were gradually rising, MPV and PDW, P - LCR and platelet platelet count PLT is highly negative phase relationship (r = 0.442, 0.395, 0.472, P < 0.01), PLT and APACHEII scores are highly negative correlation (r = 0.602, P < 0.01); Platelet membrane glycoprotein CD62P and CD63 expression level and APACHEII scores were highly positive correlation (r = 0.603, 0.619, P < 0.01); MPV and platelet CD62P and CD63 expression levels were positively correlated (r = 0.382, 0.310, P < 0.05), P - LCR, PLT, PDW and platelet CD62P and CD63 has no obvious correlation between the expression level (P > 0.05) .Conclusion: 1. Sepsis patients with early high platelet activated state in the body, the platelet parameters PLT, P - the LCR, MPV and PDW and platelet membrane glycoprotein CD62P and CD63 in platelet activation process. 2. Sepsis patients platelet membrane glycoproteins and platelet parameters can be initially determined the change of the patients, can be used as a kind of disease early warning.