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-  2018 

血小板白细胞聚集体水平在脓毒症并发急性呼吸窘迫综合征中的诊断价值

DOI: doi:10.7507/1671-6205.201705039

Keywords: 脓毒血症, 急性呼吸窘迫综合征, 血小板白细胞聚集体

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Abstract:

目的探讨脓毒症患者血小板白细胞聚集体(PLA)水平的变化以及对并发急性呼吸窘迫综合征(ARDS)的诊断价值。 方法前瞻性研究 2015 年 1 月至 2016 年 12 月入院的成人脓毒症患者。所有脓毒症受检对象检测前不分组,整理资料时按 2012“柏林定义”诊断标准将 58 例脓毒症合并 ARDS 患者作为试验组,139 例脓毒血症非 ARDS 患者作为对照组。诊断脓毒症后即刻采集肘静脉血液样本应用流式细胞术进行 PLA 检测,进行急性生理学和慢性健康状况评分系统 Ⅱ(APACHEⅡ)评分,绘制受试者工作特征(ROC)曲线。 结果试验组 PLA、血小板中性粒细胞聚集体(PNA)和血小板淋巴细胞聚集体(PLyA)高于对照组,但差异无统计学意义(均 P>0.05)。试验组血小板单核细胞聚集体(PMA)高于对照组,差异有统计学意义( P<0.05)。外周血 PMA 与 APACHEⅡ 评分呈正相关( r=0.671, P<0.001)。以 PMA 为检验变量时,ROC 曲线下面积(AUC)为 0.945,有显著的诊断价值( P<0.001),PMA 最佳临界值为 8.25%,诊断敏感性为 0.806,特异性为 0.951;以 APACHEⅡ 为检验变量时,AUC=0.930,有显著的诊断价值( P<0.001),APACHEⅡ 最佳临界值为 16.500,诊断敏感性为 0.871,特异性为 0.852。 结论PMA 对脓毒症合并 ARDS 患者的诊断具有一定价值

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