中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2014年
8期
903-907
,共5页
脓毒症%弥漫性血管内凝血%C反应蛋白%纤维蛋白原/C反应蛋白比值
膿毒癥%瀰漫性血管內凝血%C反應蛋白%纖維蛋白原/C反應蛋白比值
농독증%미만성혈관내응혈%C반응단백%섬유단백원/C반응단백비치
Sepsis%Disseminated intravascular coagulation%C reactive protein%Fibrinogen/C reactive protein ratio
目的 探讨脓毒症患者纤维蛋白原/C反应蛋白(fibrinogen/CRP)比值水平与弥漫性血管内凝血(DIC)发生的相关性.方法 选择北京大学人民医院急诊重症监护病房脓毒症患者共61例,收入急诊重症监护病房24 h内进行血常规、CRP、血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原、D-二聚体(D-dimer)水平的检测.收集纳入研究患者的临床资料,进行APACHEⅡ评分、ISTH的DIC评分及JAAM的DIC评分.根据DIC评分结果将患者分为DIC组和非DIC组,对比组间血小板、CRP、血浆凝血酶原时间(PT)、活化部分凝血活酶时间(ApTT)、纤维蛋白原水平(FIB)、Fibrinogen/CRP比值,并建立ROC曲线明确CRP,Fibrinogen/CRP比值对于诊断DIC的敏感性及特异性.计算CRP,Fibrinogen/CRP与JAAM评分诊断DIC的OR值.所有数据采用SPSS 17.0版统计软件进行分析.结果 ①DIC组Fibrinogen/CRP比值明显低于非DIC组.②ISTH的DIC评分:Fibrinogen/CRP比值ROC曲线下为0.691,高于C反应蛋白ROC曲线下0.561,纤维蛋白原ROC曲线下0.608.③JAAM的DIC评分:Fibrinogen/CRP比值ROC曲线下为0.814,高于C反应蛋白ROC曲线下0.788,纤维蛋白原ROC曲线下为0.429.④JAAM评分诊断DIC:Fibrinogen/CRP比值(＜45) OR值为11.14,CRP(＞70 mg/l) OR值为8.05.结论 Fibrinogen/CRP比值可以作为脓毒症患者DIC诊断的早期判读指标.
目的 探討膿毒癥患者纖維蛋白原/C反應蛋白(fibrinogen/CRP)比值水平與瀰漫性血管內凝血(DIC)髮生的相關性.方法 選擇北京大學人民醫院急診重癥鑑護病房膿毒癥患者共61例,收入急診重癥鑑護病房24 h內進行血常規、CRP、血漿凝血酶原時間(PT)、活化部分凝血活酶時間(APTT)、纖維蛋白原、D-二聚體(D-dimer)水平的檢測.收集納入研究患者的臨床資料,進行APACHEⅡ評分、ISTH的DIC評分及JAAM的DIC評分.根據DIC評分結果將患者分為DIC組和非DIC組,對比組間血小闆、CRP、血漿凝血酶原時間(PT)、活化部分凝血活酶時間(ApTT)、纖維蛋白原水平(FIB)、Fibrinogen/CRP比值,併建立ROC麯線明確CRP,Fibrinogen/CRP比值對于診斷DIC的敏感性及特異性.計算CRP,Fibrinogen/CRP與JAAM評分診斷DIC的OR值.所有數據採用SPSS 17.0版統計軟件進行分析.結果 ①DIC組Fibrinogen/CRP比值明顯低于非DIC組.②ISTH的DIC評分:Fibrinogen/CRP比值ROC麯線下為0.691,高于C反應蛋白ROC麯線下0.561,纖維蛋白原ROC麯線下0.608.③JAAM的DIC評分:Fibrinogen/CRP比值ROC麯線下為0.814,高于C反應蛋白ROC麯線下0.788,纖維蛋白原ROC麯線下為0.429.④JAAM評分診斷DIC:Fibrinogen/CRP比值(＜45) OR值為11.14,CRP(＞70 mg/l) OR值為8.05.結論 Fibrinogen/CRP比值可以作為膿毒癥患者DIC診斷的早期判讀指標.
목적 탐토농독증환자섬유단백원/C반응단백(fibrinogen/CRP)비치수평여미만성혈관내응혈(DIC)발생적상관성.방법 선택북경대학인민의원급진중증감호병방농독증환자공61례,수입급진중증감호병방24 h내진행혈상규、CRP、혈장응혈매원시간(PT)、활화부분응혈활매시간(APTT)、섬유단백원、D-이취체(D-dimer)수평적검측.수집납입연구환자적림상자료,진행APACHEⅡ평분、ISTH적DIC평분급JAAM적DIC평분.근거DIC평분결과장환자분위DIC조화비DIC조,대비조간혈소판、CRP、혈장응혈매원시간(PT)、활화부분응혈활매시간(ApTT)、섬유단백원수평(FIB)、Fibrinogen/CRP비치,병건립ROC곡선명학CRP,Fibrinogen/CRP비치대우진단DIC적민감성급특이성.계산CRP,Fibrinogen/CRP여JAAM평분진단DIC적OR치.소유수거채용SPSS 17.0판통계연건진행분석.결과 ①DIC조Fibrinogen/CRP비치명현저우비DIC조.②ISTH적DIC평분:Fibrinogen/CRP비치ROC곡선하위0.691,고우C반응단백ROC곡선하0.561,섬유단백원ROC곡선하0.608.③JAAM적DIC평분:Fibrinogen/CRP비치ROC곡선하위0.814,고우C반응단백ROC곡선하0.788,섬유단백원ROC곡선하위0.429.④JAAM평분진단DIC:Fibrinogen/CRP비치(＜45) OR치위11.14,CRP(＞70 mg/l) OR치위8.05.결론 Fibrinogen/CRP비치가이작위농독증환자DIC진단적조기판독지표.
Objective To determine if the fibrinogen/C reactive protein (CRP) ratio could be used in sepsis patients as a predictor for disseminated intravascular coagulation.Methods A total of 61 patients with sepsis admitted to emergency intensive care unit (EICU) were enrolled.C reactive protein (CRP) and variables of coagulation such as Platelet (PLT),prothrombin time (PT),activated partial thrombopastin time (APTT),fibrinogen and D-dimer were analyzed during 24 hours after admission to EICU.APACHE Ⅱ score,ISTH score and JAAM score were evaluated.According to DIC score (JAAM score and ISTH score),the patients were divided into two groups:overt DIC and no overt DIC.Data were expressed in mean ±standard deviation and were statistically analyzed by SPSS 17.0.The differences of CRP,PLT,PT,APTT,fibrinogen and D-dimer of patients in each group were analyzed by independent samples t test.The receiver-operating characteristics (ROC) analysis was performed to predict the diagnostic power of the variables fibrinogen,CRP,and fibrinogen/C reactive protein (CRP) ratio.In addition,the odds ratios (OR) were estimated by chi-square test and the 95％ confidence intervals were calculated.Results In overt DIC group fibrinogen/C reactive protein (CRP) ratio was significantly lower.The receiver-operating characteristic analysis showed for the fibrinogen/C reactive protein (CRP) ratio (area under the curve:ISTH criteria 0.691 and JAAM criteria 0.814) significantly better discriminative power than for fibrinogen (area under the curve:ISTH criteria 0.608 and JAAM criteria 0.429) and CRP (area under the curve:ISTH criteria 0.561 and JAAM criteria 0.788).The odds ratio for fibrinogen/C reactive protein (CRP) ratio (＜ 45) was 11.14 and CRP (＞ 70 mg/L) was 8.05.Conclusions We suggest that the fibrinogen/C reactive protein (CRP)ratio could be a diagnostic factor for the occurrence of disseminated intravascular coagulation in sepsis patients.
