Relationship between abnormality of coagulation-fibrinolysis system and prognosis of elderly critical patients in emergency department
10.3760/cma.j.issn.1673-4904.2010.03.002
- VernacularTitle:急诊老年危重患者凝血纤溶指标的变化及与病情严重程度的关系
- Author:
Hongyan WEI
;
Xin LI
;
Yujie LI
;
Hong ZHAN
;
Xiaoli JING
;
Yan XIONG
;
Chunlin HU
;
Xiaoxing LIAO
- Publication Type:Journal Article
- Keywords:
Aged;
Critical illness;
Blood coagulation;
Fibrinolysis;
APACHE
- From:
Chinese Journal of Postgraduates of Medicine
2010;33(3):4-6
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the variation of biomarker of coagulation, anti-coagulation, fibrinolysis in elderly critical patients and find out whether they are related to the disease severity. Methods Sixty-seven patients were no less than 60 years old. Eligible criteria: coincidence with the diagnostic criteria of systemic inflammatory response syndrome (SIRS) and APACHE Ⅱ score was no less than 10 scores. Blood sample was drawn from the venous for the test of biomarker (APTT, PT, TT, D-D, Fib, AT-Ⅲ , PC, PAI-1). According to the existent status,all the patients were divided into two groups:survival group (43 cases) and death group(24 cases) ,meanwhile,according to the diagnostic criteria of MODSE,all the patients were divided into MODSE group (30 cases) and non-MODSE group (37 cases). Results There were significant differences in APACHE Ⅱ score between MODSE group and non-MODSE group, survival group and death group [(25.83 ± 1.19) scores vs(18.1±20.73) scores and(18.81±0.72) scores vs(26.50 ± 1.42) scores](P <0.01). The PT and D-D in MODSE group anti death group were higher than those in non-MODSE group and survival group, the differences were significant (P <0.05),while the activity of AT-Ⅲand PC in MODSE group and death group were lower than those in non-MODSE group and survival group, the differences were significant (P <0.05). The PT,D-D and PAI-1 were positively correlated to APACHE Ⅱ score (related coefficients were 0.328, 0.308, 0.335,P <0.05). The AT-Ⅲ and PC were negatively correlated to APACHE Ⅱ score (related coefficients were -0.469, -0.559,P <0.01). Conclusions The abnormality of eoagnlation-fibfinolysis system exists in elderly critical patients. The extended PT, elevated D-D and PAI-1 ,descended PC and AT-Ⅲ are the hints of disease severity and poor prognosis.
