张红松 李培杰 陈天铎 杨兰 董晨明

    【摘要】 目的:评价血浆血栓前体蛋白(TPP)浓度变化在严重脓毒症中的意义。方法:应用酶联免疫技术测定22例严重脓毒症患者TPP浓度及凝血酶原时间(PT)、活化部分凝血激酶时间(APTT)、纤维蛋白原(Fib)、D-二聚体含量,并与10例一般感染组、8例正常对照组进行比较。同时动态观察严重脓毒症患者收入重症监护治疗病房(ICU)后第1、3和5 d各项凝血指标，及与感染相关器官衰竭评分系统(SOFA)、简化急性生理评分系统Ⅱ(SAPSⅡ)、Marshall多器官功能障碍综合征评分进行相关性分析。结果: ①严重脓毒症组TPP浓度与D-二聚体含量阳性率显著高于一般感染组和正常对照组(P均<0.05)，而PT、APTT、Fib在3组间差异均无显著性(P均>0.05)。②严重脓毒症死亡患者的TPP浓度持续升高，与SOFA、SAPSⅡ、Marshall评分呈正相关。结论: TPP可作为严重脓毒症预后及早期高凝状态的诊断指标；与PT、APTT、Fib、D-二聚体相比具有更高的敏感性和特异性。

    【关键词】 血栓前体蛋白； 严重脓毒症； 高凝状态

    Clinical significance of detection of thrombus precursor protein in severe sepsis

    ZHANG Hong-song, LI Pei-jie, CHEN Tian-duo, YANG Lan, DONG Chen-ming.

    Second Hospital of Lanzhou University, Lanzhou Emergency Center of Gansu Province, Lanzhou 730030, Gansu, China

    【Abstract】 OBJECTIVE:： To evaluate the significance of the changes in plasma thrombus precursor protein (TPP) in severe sepsis. METHODS:：Enzyme linked immunoadsorbent assay (ELISA) was used in the determination of plasma TPP in 22 patients with severe sepsis group. Prothrombin time (PT), activated partial thromboplastin time(APTT), fibrin(Fib), D-Dimer were also determined and the values were compared with those obtained from 10 patients with infection and 8 healthy normal controls. At the same time, scores of sepsis related organ failure assessment(SOFA), simplified acute physiology score (SAPSⅡ), Marshall criteria were made respectively in patients with severe sepsis on 1 ......