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及低分子肝素和小剂量尿激酶干预治疗的效果。方法 应用酶联免疫技术测定 2 5例严重脓毒症患者TPP浓度及PT、APTT、Fib、D -Dimer,并与 10例一般感染者、8例正常对照者进行比较。同时将严重脓毒症患者随机分为治疗组与对照组 ,治疗组给予低分子肝素和小剂量尿激酶及常规治疗 ,对照组仅给予常规治疗 ,比较两组TPP浓度的变化。结果 ①严重脓毒症组TPP浓度与D -Dimer阳性率显著高于一般感染组、正常对照组 (P均 <0 0 5 ) ,而PT、APTT、Fib在三组间差异无显著性 (P均 >0 0 5 )。②治疗组TPP浓度较对照组显著降低 (P均 <0 0 5 ) ,但死亡率无差异 (P >0 0 5 )。结论 TPP测定可反映严重脓毒症的高凝状态 ,且比PT、APTT、Fib、D -Dimer具有更高的敏感性和特异性 ,可作为严重脓毒症早期高凝状态的诊断指标。低分子肝素和小剂量尿激酶的干预治疗可降低TPP的浓度 ,但对预后无影响。
Objective To evaluate the significance of the concentration change of plasma thrombus precursor protein (T PP) in severe sepsis and intervention therapy of low molecular weight heparins and low dose of urokinase. Methods Enzyme linked immunosorbent assay (ELISA) was used in the detection of plasma T PP in 25 patients with severe sepsis group . PT , APTT , Fib , D-Dimer were detected and statistical comparison was carried out in 10 patients with ordinary infection and 8 healthy normal controls. At the same time , severe sepsis group were randomly divided into two groups,the 13 patients in the treated group were treated with low molecular weight heparins and low dose of urokinase and conventional treatment,and the 12 patients in the control group were treated with conventional treatment alone.The concentration change of T PP of two groups were compared. Results ① The concentration of T PP and positive rate of D-Dimer in severe sepsis were obviously higher than those in the ordinary infection group and normal control group (all P<0.05), but levels of PT,APTT,Fib weren't significantly different among three groups. ② The concentration of T PP of the treated group decreased more obviously than that of the control group. Conclusions T PP detection shows hypercoagulable states of severe sepsis and has higher specificity and sensitivity than D-Dimer , PT, APTT , Fib assay .It can be used as a diagnosis parameter for early hypercoagulable states of severe sepsis. Though intervention therapy of low molecular weight heparins and low dose of urokinase can decrease the concentration of T PP , it has no influence on prognosis.
出处
《中国急救医学》
CAS
CSCD
北大核心
2005年第1期4-6,共3页
Chinese Journal of Critical Care Medicine
基金
甘肃省自然科学基金暨中青年科技基金项目 (ZS991-A2 3 -0 74-Y)
关键词
血栓前体蛋白
严重脓毒症
肝素
尿激酶
Thrombus precursor protein(T PP)
Severe sepsis
Heparins
Urokinase
