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目的 探讨老年重症脓毒症患者的凝血功能变化及与预后的关系.方法 选取2016年3月-2017年2月任丘市华北石油管理局总医院老年重症脓毒症患者149例,于入院第1天测定凝血功能、D二聚体和血小板水平,并计算APACHEⅡ评分.分析不同水平的APACHEⅡ评分与凝血功能、D二聚体及血小板水平的关系.并根据预后将患者分为存活组和死亡组,比较两组的凝血功能、D二聚体和血小板水平.结果 死亡组血小板水平显著低于存活组,APACHEⅡ评分、PT、INR、APTT和D二聚体阳性率均显著高于存活组(P<0.05);随着APACHEⅡ评分分值升高,PT、INR、APTT、FIB、D二聚体阳性率及死亡率均明显升高(P<0.05),血小板水平显著降低(P<0.05).结论 老年重症脓毒症患者的凝血功能与预后显著相关,病情越重,凝血功能越差,血小板水平越低,死亡率越高.“,”Objective To explore the relationship between coagulation function and APACHE II score and prognosis in the elder patients with severe sepsis. Methods One hundred and forty-nine elder patients with severe sepsis were enrolled. The levels of coagulation function, D-dimer, platelet and the APACHEⅡ scores were evaluated at the 1st day in the hospital. The relationships between APACHE Ⅱ score and the coagulation function, D-dimer or platelet levels were analyzed.According to the prognosis,the patients were divided into two groups,the alive group and dead group. The coagulation function, D-dimer and platelet levels in two groups were compared. Results There were significant lower platelet levels in dead group than alive group.however,The levels of PT,INR,APTT,fibrinogen(FIB) and the positive ratio of D dimer,dead rate were significant increased alone with the elevation of APACHEⅡscore (P<0.05),and the platelet levels decreased(P<0.05).Conclusions In the elder patients with severe sepsis,the state of illness was more serious,the coagulation function was more disordered,the platelet levels were more lower and the dead rate was much more.