Coagulation Disorders And Thromboelastography Relationship With Severity And Prognosis In The Patients With Sepsis

Objective:To obverse the relationship between coagulation disorders and severityand prognosis in the patients with sepsis. To investigate the relationship betweenthromboelastography and standard coagulopathy tests in the septic patients.Methods:31patients with sepsis were chosen in our respiratory intensive care unit（RICU）from Mar2012to Feb2013.The patients were divided into three groupsbased on acute physiology and chronic Health Evaluation(APACHE)Ⅱ, which werenon risk group A(APACHEⅡscore<12), the risk group B(APACHE score12~25)and the high risk group C(APACHEⅡscore>25)，and then the patients were dividedinto DIC group and non-DIC group based on overt DIC scoring system, were dividedinto survival group and death group according to prognosis. Then standardcoagulopathy tests、DD、PLT and thromboelastography were detected.The results ofstandard coagulopathy tests、DD、PLT and thromboelastography were compared andthe relationship between thromboelastography and standard coagulopathy tests andPLT were investigated.Results:1.Compared with group Aand group B，PLT in group C was significantly lower， DD and PT were significantly higher.(P<0.01)．Compared with group B，APTT ingroup C was significantly longer.Compared with group A, APTT in group B wassignificantly longer.(P<0.01).2.Compared with non-DIC group，PLT in DIC group was significantly lower，DD、APTT and PT were significantly higher.(P<0.05)3.Compared with survival group，PLT in death group was significantly lower，DD、APTT and PT were significantly higher.(P<0.05)4.Compared with group Aand group B，R and K were significantly higher，butMAand Angle were significantly lower in group C.(P<0.05)5. Compared with non-DIC group，R and K were significantly higher，but MAand Angle were significantly lower in DIC group.(P<0.05)6. Compared with survival group，R and K were significantly higher，but MAand Angle were significantly lower in death group.(P<0.05)7. According to the the relevance analysis， there was negative correlationbetween R and PLT(r=-0.490)， but was positive correlation between R andDD(r=0.599).There was positive correlation between MA and PLT(r=0.800)、FIB(r=0.794)，but was negative correlation between MA and APTT(r=-0.554)、PT(r=-0.687)、 TT(r=-0.797). There was positive correlation between Angle andPLT(r=0.736)， but was negative correlation between Angle and PT(r=-0.704)、TT(r=-0.699).There was negative correlation between K and PLT(r=-0.729)，but waspositive correlation between K and DD(r=0.515)、PT(r=0.606)、TT(r=0.656).Conclusion：There were universally coagulation disorders in the patients with sepsis.The degree of coagulation disorders is was associated with severity and prognosis.Thromboelastography was good for evaluation the function of coagulation.Meanwhile what standard coagulopathy tests and thromboelastography detected were significant for estimating severity and prognosis in the patients with sepsis.