Abnormality Of Coagulation Functions In Assessing The Prognosis Of Acute And Critically Patients

Objective:Biology was further confirmed with the degree of danger of PT,APTT,Ddimer,PLT,LAC,Alb,RDW and PCT and other signs of critically ill patients and correlation of critical patients prognostic significance.Methods:200 cases critically ill patients were Selected from January 2012 to December2015 in our Hospital intensive medicine treatment,200 cases admitted within 24 hours by detecting their peripheral blood PT,APTT,D-dimer,PLT,LAC,Alb,RDW and PCT and other biological markers,and APACHEⅡ score within 24 hours,according to APACHEⅡ score <15,15-25,and> 25 divided into three groups for the three sets of indicators to compare and understand these indicators critically ill correlation analysis of the degree of correlation between each indicator and APCHEⅡ scores.According to the prognosis of the patients were divided into death group and survival group were compared PT,APTT,D-dimer,PLT,LAC,Alb,RDW,PCT and APACHEⅡ whether the difference was statistically significant for statistical significance indicators depicting a receiver operating characteristic(ROC curve),used as critically ill patients to assess the prognostic value.Results:APACHEⅡ score <15,15-25,and> 25 points three groups of plasma PT,APTT,D-dimer,Alb,PLT,LAC,RDW and PCT level,including PT,APTT,D-dimer,PLT,LAC significant difference was statistically significant(P <0.01).When the correlation analysis PT,APTT,D-dimer,Alb,PLT,LAC,RDW and PCT levels and APACHEⅡ scores,PT,APTT,D-dimer,PLT,LAC APACHEⅡ scores were correlated with the more good(r = 0.439,0.481,0.525,-0.500,0.681).According to the presence or absence of death in critically ill patients were divided into two groups of death and survival,were compared between the two groups of plasma PT,APTT,D-dimer,Alb,PLT,LAC,RDW,PCT levels and APACHEⅡ score.Wherein a difference PT,APTT,D-dimer,Alb,PLT,LAC and APACHEⅡ scores have significant statistical significance(P <0.01).The infection in critically ill patients were divided into groups and the non-infected group differences in the two groups PCT,PCT levels of infection than non-infected group were significantly different(P <0.01).PT plasma area under the ROC curve in predicting the incidence of death in critically ill patients is 0.734,95% CI(0.665-0.804).In plasma PT level 16.25 sec,the judgment occur in critically ill patients died optimal sensitivity and specificity,sensitivity 55.3%,specificity was 84.0%.The area under the ROC curve of plasma APTT levels in critically ill patients to predict the incidence of death was 0.721,95% confidence interval(0.649-0.793).When plasma APTT level47.55 sec,determine the occurrence of critically ill patients died optimal sensitivity and specificity,sensitivity 52.1%,specificity of 89.6%.The area under the ROC curve of plasma D-dimer levels predict the incidence of death in critically ill patients is0.716,95% confidence interval(0.646-0.786).In plasma D-dimer 1805,the judge of death occur in critically ill patients the best sensitivity and specificity,sensitivity 56.4%,specificity of 74.5%.The area under the ROC curve of serum albumin levels predict the incidence of death in critically ill patients is 0.369,95% confidence interval(0.290-0.448).Description judgment of death in critically ill patients is very low incidence value.In plasma albumin as 28.05,the judgment occur in critically ill patients died optimal sensitivity and specificity,sensitivity was 47.9%,a specificity of 24.5%.The area under the ROC curve platelet levels predict the incidence of death in critically ill patients is 0.231,95% confidence interval(0.165-0.296).Description low prognostic value.In PLT level was 98.5,the judgment occur in critically ill patients died optimal sensitivity and specificity,sensitivity 43.6%,specificity of 12.3%.The area under the ROC curve lactate levels predict the incidence of death in critically ill patients is0.850,95% confidence interval(0.796-0.904).In LAC blood levels 2.25 mmol / L,the judgment occur in critically ill patients the best sensitivity and specificity of death,a sensitivity of 84% and a specificity of 75.5%.The area under the ROC curve APACHEⅡ score predicts the incidence of death in critically ill patients is 0.853,95%confidence interval(0.801-0.905).In APACHEⅡ level of 21.5,the judgment occur in critically ill patients died optimal sensitivity and specificity,sensitivity 74.5%,specificity of 82.1%.Conclusion:There was significant abnormalities in Critically patients of PT,APTT,Ddimer,PLT,LAC with critical illness severity increases.The difference was significant statistically significant(P <0.01).PT,APTT,D-dimer,LAC and APACHEⅡ score was significantly elevated positive correlation,PLT and raised APACHEⅡ score was negatively correlated.There was an important clinical significance for prognosis of critically ill patients by monitoring the level of the plasma PT,APTT,D-dimer,LAC and APACHEⅡ score.There was an important clinical significance to determine infections by monitoring the level of PCT.