The Correlation Analysis Between APTT、FIB、PT、TT、PLT And Blood Lactate In The Sepsis Patient

Objective Blood coagulation function, ABL and other clinical indicators are commonly used in the treatment of sepsis. Some researches shows that patients these indicators have a closely relative ship with the prognosis of sepsis, but all the parameter is used to judge the prognosis of patients with sepsis still need to do lots of research.This study was designed to investigate APTT,FIB,PT,TT,PLT and lactic acid,then how to impact the prognosis of sepsis.Methods1.The research object is 178 patients who came to ICU of the first hospital affiliated to Jinan university in January 2013 to June 2014.According to the extent of the disease is divided into sepsis, severe sepsis and control groups; each group according to the prognosis of different and divided into survival group and death group.2.Detect the coagulation function, lactic acid, blood gas analysis of patients came to ICU within 2 hours; and exam the above indicators interval of four hours if the patient with an coagulation disorder.3.Analyze the data using SPSS19.0 software.Results:1.All of the 178 subjects, 118 people survived, 60 died, 28 day mortality rate was 32.6%.In the control group(58), sepsis(53) and severe sepsis group(67) number of survival and death number 43, 15, 34, 19, 41, 6, respectively. The mortality rates were 25.8%, 35.8%, 38.8%.Between the two groups in age, sex had no statistical difference(p>0.05).2. In control group, sepsis group, severe sepsis group comparison, activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),ABL,APACHEⅡlevels increased with the degree of disease aggravation. In severe sepsis group the increase is significant(P<0.05). Compared with the survival group, the levels of APTT,APACHE,PT,TT,ABL,APACHEⅡin the death group were significantly higher,and it was statistically significant(P<0.05). It is suggested that PT, TT, APTT, ABL and APACHEⅡhave a certain reference value for predicting the severity and prognosis of sepsis.3.Coagulation function in normal group and abnormal group was compared according to the level of 0.05 test. The results showed that two groups of ABL,APACHEⅡwas the number of levels of different and coagulation function in abnormal group level lower,the difference hasstatistical significance,P<0.05; ABL<4mmo L/L group and ≥4mmo L/L group comparison,according to the level of 0.05 test, the results showed APTT, PT, APACHEⅡwas the number of levels to different, the difference has statistical significance(P<0.05). The difference of FIB,TT and PLT in the two groups was not statistically significant.4.APTT, PT, ABL respectively and APACHEⅡfor correlation test results: R values were0.439,0.472,0.359,and P<0.01.The positive linear relationship existed between them.5.APTT,PT and ABL correlation test, r=0.394,0.464 and p<0.01). To reveal the existence of linear correlation relationship between APTT,PT and ABL.6.The PT,AGE,ABL,APTT,PLT and APACHEⅡ correlation of multivariate regression analysis,and finally establish the regression equation:Y(APACHEⅡ)=2.864 +5.276×X1(PT)+0.209×X2(AGE) +0.121×X3(ABL)+0.477×X4(APTT)-0.102×X5(PLT). They suggest that there is a linear relationship. PT,ABL,APTT,AGE was positively correlated with APACHEⅡ,PLT was negatively correlated with APACHEⅡ.These indicators for judging the severity of illness and the prognosis of sepsis patients has certain clinical value. In the multi factor regression analysis and draw a conclusion that: PT,APTT,PT,AGE,ABL,PLT regression coefficient according to the order from small to large display: 5.276,0.477,0.209,0.121,0.102.Conclusions:1.APTT,PT,ABL and APACHEⅡpresent linear correlation,indicating APTT,PT and ABL and APACHEⅡin assessment of patients with sepsis severity and prognosis have great clinical reference value.2 APTT, PT and ABL show linear correlation between coagulation dysfunction and tissue oxygen metabolism.It suggest that APTT,PT,ABL have a certain clinical reference value for the severity and prognosis of patients with sepsis.3. In the early stage of sepsis,PT were more valuable for the prognosis of sepsis than ABL,APTT and PLT.