| Sepsis has become one of the important reasons that endanger the health of our people.It is the main cause of death in clinically common patients with acute and critical illness.The main reason is due to the host`s excessive inflammatory response to infection caused by the associated immune paralysis or suppression,resulting in multi-organ dysfunction,which is not only a systemic inflammatory response,but also a breakdown of the host’s immune balance.Because of the ferocity of sepsis,the rapid progress of the disease,the high rate of death,clinical treatment work has great difficulties.How to identify early,diagnose and effectively prevent the occurrence and development of sepsis is the key to overcome the emergency treatment.Studies have shown that platelet plays an important role in inflammation and is of great significance in the occurrence,development,and outcome of inflammation.By observing the status of the patient’s platelet activation,it can respond to the body’s inflammatory response and the severity of the disease.It has been reported at home and abroad that platelet parameters are closely related to sepsis,which can indicate the occurrence and development of sepsis.This study used retrospective studies to analyze the platelet(PLT),mean platelet volume(MPV),platelet distribution width(PDW),and platelet large cell ratio(P-LCR)of patients with sepsis to determine the correlation between plate parameters and the severity and prognosis of sepsis.Objective:To study the correlation between platelet parameters and the severity and prognosis of patients with sepsis.Methods:A collection of 112 sepsis patients in the emergency department of the Affiliated Hospital of Chengde Medical College from October 2018 to October 2020 as an observation group.Collected 60 cases of simultaneous health check-ups According to the severity of the disease as a control group.According to the China Sepsis / Sepsis Shock Emergency Treatment Guide(2018),they can be divided into sepsis group and septic shock group.The collected clinical data of patients include:(1)General items: gender,age,diagnosis and complications,number of days in hospital,and outcome(survival or death).(2)Whether there is a history of tumors,whether there is a history of common chronic diseases involved in the acute physiology and chronic health assessment standard II(APACHE II)scores in patients with acute and critical illness,etc.(3)Record the procalcitonin(PCT),white blood cell count(WBC),neutrophil count(NEUT),arterial blood lactate,platelet count(PLT),platelet within 24 hours of the patient’s emergency department visit Mean volume(MPV),platelet distribution width(PDW),large platelet ratio(P-LCR).Select the worst value of clinical indicators within 24 hours for the corresponding APACHEII score.According to the patients’ 28-day survival,112 patients were divided into survivor group(n=77)and death group(n=35).Analyze and compare the differences in platelet parameters and APACHE II score between the sepsis group and the septic shock group,and then study the relationship between platelet parameters and the severity of sepsis.Analyze and compare the differences in platelet parameters between the survivor group and the death group,and evaluate the relationship between platelet parameters and the prognosis of sepsis.Analyze the correlation between the death group of sepsis and the parameters of platelet,and then obtain the correlation between PLT,MPV,PDW,P-LCR and the prognosis of patients with sepsis.Use ROC curve analysis to compare the relationship between platelet parameters and the prognosis of sepsis,and further analyze the relationship between platelet parameters and the prognosis of patients with sepsis.The statistical processing is to use SPSS 26.0 to analyze the statistical results.Result:1.The observation group was compared with the normal control group:PLT(133.50±39.63),MPV(11.32±1.36),PDW(15.19±2.37),P-LCR(31.20±5.66),normal control group PLT(255.05±49.68),MPV(10.21±0.73),PDW(11.98±1.41),P-LCR(24.13±7.20),statistical analysis showed that the observation group PLT is lower than the normal control group,the observation group MPV,PDW,P-LCR are higher than the normal control group,the two groups of platelets have significant differences in parameters(P<0.001).2.Comparison between sepsis group and septic shock group: sepsis group PLT(153.20±42.30),MPV(10.78±1.19),PDW(14.05±1.94),P-LCR(28.23±5.36),PCT(5.15±2.59),APACHE II(14.58±6.94),compared to septic shock group PLT(110.77±19.13),MPV(14.05±1.94),PDW(16.51±2.12),P-LCR(34.64±3.75),PCT(6.82±2.99),APACHE II(20.69±7.71).The analysis results showed that the Septic shock group PLT was lower than that of sepsis group,and the Septic shock group MPV,PDW,P-LCR,PCT,APACHE II score higher than that of sepsis group,and there was a significant difference in the parameters of platelets between the two groups(P<0.001).3.The survivor group was compared with the death group: the survivor group PLT(143.71±42.34),MPV(10.97±1.32),PDW(14.50±2.29),P-LCR(30.20±5.84),PCT(5.22±2.71),APACHE II(14.81±6.88)compared to death group PLT(111.03±19.10),MPV(12.09±1.12),PDW(16.70±1.77),P-LCR(33.41±4.57),PCT(7.48±2.70),APACHE II(23.17±6.93),the death group PLT was lower than the survivor group,the death group MPV,PDW,P-LCR,PCT,APACHE II scores were higher than the survivor group,the difference between the two groups was statistically significant(P<0.05).4.Comparison of each parameter of platelets in the death group of sepsis with PCT and APACHEII score: Correlation with PCT: PLT of sepsis(r=-0.582,P<0.001)was negatively correlated with PCT of the death group,while MPV(r=0.432,P<0.05),PDW(r=0.342,P<0.05)was positively correlated with the PCT of the death group,but P-LCR(r=0.267,P>0.05)was not correlated with the PCT of the death group;Correlation with APACHE II score: PLT for sepsis(r=-0.503,P<0.05)was negatively correlated with APACHE II,and PDW(r=0.556,P<0.05)is positively correlated with APACHE II,but MPV(r=0.283,P>0.05),P-LCR(r=0.080,P>0.05)are not correlated with APACHE II.Correlation analysis suggests that the correlation between P-LCR and sepsis prognosis needs to be confirmed by further tests.5.The application of ROC curve indicates that platelet parameters are related to the prognosis of patients with sepsis,and the AUC curve area of platelet parameters is PLT(0.260,95%CI:0.171-0.350,P<0.001),MPV(0.755,95%CI: 0.661-0.849,P<0.001),PDW(0.769,95%CI: 0.682-0.857,P<0.001),P-LCR(0.662,95% CI: 0.557-0.767,P<0.05).Conclusion:1.The results suggest that there is a negative correlation between the severity and prognosis of PLT and sepsis,and that the MPV,PDW,PCT,APACHE II score is positively correlated with the severity and prognosis of sepsis patients.2.The results showed that there was a certain negative correlation between PLT and sepsis prognosis,MPV,PDW,PCT,APACHE II score had a positive correlation with sepsis prognosis.Correlation analysis suggests that the correlation between P-LCR and sepsis prognosis needs to be confirmed by further tests. |
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