Changes And Significance Of Coagulation Of Sepsis Patients

Objective:To analyze the changes of coagulation in sepsis patients; To analyze the relationship between coagulation and APACHE Ⅱ score; To explore the value of coagulation-related indicators for assessing condition and prognosis in sepsis patients.Methods:A total of81sepsis patients that come from Intensive Care Unit of the first affiliated hospital of Guangxi Medical University were enrolled in study from May2009to May2011.49cases were males and32cases were females. They were19to85years old. The average age were59±16years old. They were monitored of vital signs closely in the ICU within24hours. They were checked in peripheral blood, liver function, kidney function, electrolytes, coagulation (PT, APTT, FIB, TT) and arterial blood gas analysis. They were recorded the fastest heart rate, the fastest respiratory rate and the lowest mean arterial pressure within24hours, They were calculated GCS score and APACHE Ⅱ score. According to APACHE Ⅱ score they were divided into3groups:The score less than10was group A; The score10to20was group B; And the score greater than20was group C. According to the prognosis of patients were divided into the survival group and death group. According to the coagulation tetrachoric and platelet count they were divided into2groups:the one whose blood coagulation indexes was normal and the other one was abnormal.Results:1.The group of sepsis patients whose blood coagulation indexes was abnormal compare with the other group:The age was older, the APACHE Ⅱ score and the mortality rate was higher.2. The death group compare with the survival group:Platelet count was decreased (P<0.05). Prothrombin time (PT) and activated partial thromboplastin time (APTT) were prolonged in the death group (P<0.05). The APACHE Ⅱ score was higher than the survival group (P<0.05). The age in death group was older than the survival group (P<0.05). The thrombin time (TT) and fibrinogen had no difference between two groups (P>0.05).3. The comparison of coagulation index in the groups with different APACHE Ⅱ score:Prothrombin time (PT) and activated partial thromboplastin time (APTT) in group B was longer than the group A. And prothrombin time (PT) and activated partial thromboplastin time (APTT) in group C was longest. The difference had statistics significance (P<0.05); The platelet count in group B was higher than group C, and the platelet count in group A was highest. The difference had statistics significance (P<0.05).The thrombin time (TT) and fibrinogen (FIB) had no difference in three groups (P>0.05).Conclusions:1.The mortality rate of patients with sepsis whose blood coagulation indexes was abnormal was higher.2. Elderly patients with sepsis were easily combined with coagulopathy; The condition was serious and the mortality was higher.3. APACHEⅡ score may reflect the severity of sepsis patients, the higher score the more severe condition, and the mortalitywas higher.4.The coagulation-related indicators:PLT, PT, APTT was closely related with the APACHE Ⅱ score. With the increasing of APACHE Ⅱ score, PT and APTT was prolonging, but PLT was declining. Detection of PT, APTT and platelet count in judging prognosis and assessing the severity of sepsis patients have some significance.