伴血小板减少的严重脓毒症继发血小板增多症的危险因素分析

李萍; 周军; 郑欣; 王静; 杨宁; 张丽; 张明; 黄婉

doi:10.13201/j.issn.1009-5918.2017.04.006

伴血小板减少的严重脓毒症继发血小板增多症的危险因素分析

- 1. 西安交通大学第二附属医院急诊科(西安, 710004);
- 2. 陕西省靖边县中医医院急诊科

详细信息

通讯作者: 李萍, E-mail:61697601@qq.com

中图分类号: R631

收稿日期: 2017-03-02

Risk factors on thrombocythemia secondary to severe sepsis with thrombocytopenia

- 1 Department of Emergeny, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China;
- 2 Department of Emergeny, Jingbian Hospital of Traditional Chinese Medicine

More Information

Corresponding author: LI Ping, E-mail: 61697601@qq.com

Received Date: 02 March 2017

摘要

摘要: 目的: 探讨急诊ICU伴血小板减少的严重脓毒症继发血小板增多症患者的临床特征及危险因素。方法: 回顾性分析2014-01-2016-01我院急诊ICU收治的214例伴血小板减少的严重脓毒症患者的临床资料,对于存活组的血小板计数进行监测,根据有无继发性血小板增多症分为血小板增多症组与非血小板增多症组,并进行对照分析,采用Logistic回归模型进行多因素分析,明确伴血小板减少的严重脓毒症继发血小板增多症的危险因素。结果: 2年间急诊ICU伴血小板减少的严重脓毒症患者的存活率为46.26%(99/214),其中继发血小板增多症者占存活组的46.46%(46/99),2组年龄、降钙素原、既往血栓史及恶性肿瘤史4项指标比较差异有统计学意义。单因素回归分析显示,年龄(OR=0.955,P<0.01)、APACHEⅡ评分(OR=0.898,P<0.05)、降钙素原(OR=1.039,P<0.05)、既往血栓史(OR=4.300,P<0.01)及恶性肿瘤史(OR=3.427,P<0.05)5项指标为影响血小板增多的相关因素。多因素Logistic回归分析显示,年龄(OR=0.959,P<0.01)、既往血栓史(OR=5.595,P<0.01)、既往恶性肿瘤史(OR=3.818,P<0.05)为影响伴血小板减少的严重脓毒症继发血小板增多的高危因素。结论: 伴血小板减少的严重脓毒症易继发血小板增多症,高龄、既往血栓史及肿瘤史为其高危因素。
- 脓毒症 /
- 血小板 /
- 危险因素 /
- Logistic回归分析
Abstract: Objective: To investigate the clinical characteristics and risk factors of thrombocythemia secondary to severe sepsis with thrombocytopenia in emergency ICU. Method: Clinical analysis of 214 cases with severe sepsis with thrombocytopenia in our hospital emergency ICU from January 2014 to January 2016,the platelet count of survival group was monitored,according to the presence or absence of secondary thrombocytosis.The survivor were divided into thrombocytosis group and non-thrombocythemia group.Multivariate analysis was performed using the Logistic regression model to identify the risk factors for thrombocytopenia with severe sepsis with thrombocytopenia. Result: The survival rate of ICU of severe sepsis with thrombocytopenia was 46.26%(99/214) in 2 years,among which thrombocythemia accounted for 46.46%(46/99).There were statistical difference between the two group on four index such as age,procalcitonin,previous history of thrombosis and history of malignancy.Single factor regression analysis showed that five index such as age(OR=0.955,P<0.01),APACHEⅡ score(OR=0.898,P<0.05),procalcitonin(OR=1.039,P<0.05),previous history of thrombosis(OR=4.300,P<0.01)and history of malignancy(OR=3.427,P<0.05)were the related factors of thrombocythemia..Multivariate logistic regression analysis showed that age (OR=0.959,P<0.01),history of previous thrombosis (OR=5.595,P<0.01),history of previous malignancy (OR=3.818,P<0.05) were correlative factors impacting thrombocythemia secondary to severe sepsis with thrombocytopenia. Conclusion: With thrombocythemia secondary to severe sepsis with thrombocytopenic,age,previous history of thrombosis and tumor history are high risk factors.
- sepsis /
- platelet /
- risk factors /
- Logistic regression analysis

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