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目的:探讨脓毒症患者降钙素原及血小板指标变化与病死率等相关性,以期指导临床。方法:选择符合入选条件的脓毒症患者78例,入院即刻查血常规、降钙素原及行血培养,入院第4天复查血常规,血培养结果依据细菌染色分为革兰氏染色阴性(G-)和革兰氏染色阳性(G+)。①依据降钙素原值分组,A组(>100μg/L)、B组(10~100μg/L)、C组(1.5~10μg/L)、D组(<1.5μg/L),比较各组入院30d病死率、血培养细菌G-和G+菌例数及病因差异;②依据入院时血小板数值将所有脓毒症患者分为血小板减少1组与血小板正常1组,后组依据入院第4天血小板数值分为血小板减少2组与血小板正常2组,比较组间病死率等。结果:所有脓毒症患者,随降钙素原增加,病死率增加,同时G-细菌所占比例增加,肺部感染增多。脓毒症患者入院3d后血小板减少,增加病死率。结论:脓毒症患者入院降钙素原数值在一定程度上可指导临床选择抗菌素及指导预后。脓毒症患者入院3d后血小板减少增加病死率。
Objective: To investigate the correlation between the change of procalcitonin, platelet index and mortality in patients with sepsis so as to guide the clinical practice. Methods: Seventy-eight patients with sepsis who met the inclusion criteria were enrolled in the study. Blood samples were routinely collected for procalcitonin, procalcitonin and blood culture. Blood routine examination was performed on the fourth day after admission. The results of blood culture were divided into Gram stain negative (G-) and Gram-positive (G +). Group A (> 100μg / L), Group B (10-100μg / L), Group C (1.5-10μg / L) and Group D (1.5μg / L) Group 30d mortality, blood culture bacteria G- and G + bacteria cases and etiological differences; ② based on admission platelet values of all sepsis patients were divided into thrombocytopenia group 1 and platelet normal group 1, the latter group based on admission 4 Day platelet values were divided into two groups and thrombocytopenia normal platelet 2 group, compared between the mortality rate and so on. RESULTS: In all patients with sepsis, as procalcitonin increased, case fatality increased, while the proportion of G-bacteria increased and lung infections increased. Sepsis patients admitted to hospital after 3d thrombocytopenia, increased mortality. Conclusion: The value of procalcitonin in sepsis patients can guide clinical choice of antibiotics and guide the prognosis to a certain extent. Thrombocytopenia increased mortality after 3 days of admission to patients with sepsis.