CAJ | 학술논문

目的探讨脓毒症患者外周血血小板-白细胞聚集体（ PLA）水平变化的意义。方法将100例脓毒症患者分为感染性休克组30例，严重脓毒症组40例，脓毒症组30例，应用流式细胞术检测外周血血小板-中性粒细胞聚集体（ PNA）和血小板-单核细胞聚集体（ PMA）水平，并与30例健康者（对照组）进行比较。以28 d为终点比较预后良好组与预后不良组患者的外周血PLA水平、急性生理学与慢性健康状况评分Ⅱ（ APACHEⅡ）和序贯器官衰竭估计评分（SOFA）。结果脓毒症患者外周血PMA和PNA水平明显高于对照组（P＜0．01）；感染性休克组外周血PMA和PNA水平明显高于严重脓毒症组、脓毒症组和对照组（P＜0．01）；严重脓毒症组外周血PMA和PNA水平明显高于脓毒症组和对照组（P＜0．01）；脓毒症组外周血PMA和PNA水平明显高于对照组（ P＜0．05）；预后不良组外周血PMA和PNA水平、APACHEⅡ和SOFA评分明显高于预后良好组（P＜0．01）。结论脓毒症患者外周血PLA水平升高，并与脓毒症严重程度有关，脓毒症患者预后不良组外周血PLA水平高于预后良好组，提示PLA可能在脓毒症损伤机制中起着重要作用。
목적탐토농독증환자외주혈혈소판-백세포취집체（ PLA）수평변화적의의。방법장100례농독증환자분위감염성휴극조30례，엄중농독증조40례，농독증조30례，응용류식세포술검측외주혈혈소판-중성립세포취집체（ PNA）화혈소판-단핵세포취집체（ PMA）수평，병여30례건강자（대조조）진행비교。이28 d위종점비교예후량호조여예후불량조환자적외주혈PLA수평、급성생이학여만성건강상황평분Ⅱ（ APACHEⅡ）화서관기관쇠갈고계평분（SOFA）。결과농독증환자외주혈PMA화PNA수평명현고우대조조（P＜0．01）；감염성휴극조외주혈PMA화PNA수평명현고우엄중농독증조、농독증조화대조조（P＜0．01）；엄중농독증조외주혈PMA화PNA수평명현고우농독증조화대조조（P＜0．01）；농독증조외주혈PMA화PNA수평명현고우대조조（ P＜0．05）；예후불량조외주혈PMA화PNA수평、APACHEⅡ화SOFA평분명현고우예후량호조（P＜0．01）。결론농독증환자외주혈PLA수평승고，병여농독증엄중정도유관，농독증환자예후불량조외주혈PLA수평고우예후량호조，제시PLA가능재농독증손상궤제중기착중요작용。
@@@ Objective To investigate circulating levels of platelet -leukocyte aggregates ( PLA) in patients with sepsis .Me thods A total of 100 sepsis patients were enrolled , including 30 sepsis patients, 40 severe sepsis patients and 30 septic shock patients .Circulating levels of platelet -neutrophil aggregates ( PNA ) and platelet -monocyte aggregates ( PMA ) were quantitatively analyzed by flow cytometry.With 28 days as end point, circulating levels of PLA, acute physiology and chronic health evaluation (APACHEⅡ) score and sequential organ failure assessment (SOFA) score were compared with different prognosis respectively .Results Circulating PMA and PNA levels were significantly higher in 100 sepsis patients than those in controls (P<0.01).The rank of circulating PMA and PNA levels in patients was:septic shock patients >severe sepsis patients >sepsis patients >controls, with significant difference among the groups (P<0.01).Compared to the patients with good prognosis (63 cases), circulating PMA and PNA levels , APACHEⅡscore and SOFA score in those with poor prognosis ( 37 cases) were significantly increased (P<0.05).Conclusion PLA levels are increased significantly in patients with sepsis and associated with the severity of sepsis , suggesting that platelet is involved in the pathogenesis of sepsis and PLA indicates the disease process in patients with sepsis .