Rowe M I, Buckner D M, Newmark S
Ann Surg. 1975 Sep;182(3):280-6. doi: 10.1097/00000658-197509000-00010.
Ninety-three postoperative patients 1 day to 13 years of age had blood cultures, limulus lysate assay, determination of fibrin degradation products, white blood cell and platelet counts. Seven groups were studied. The limulus lysate assay was often positive (64%) in the presence of gram negative septicemia but there were false positives and negatives. The tests for fibrin degradation products were inconsistent. The white blood cell count was low in babies with gram negative septicemia. One hundred per cent of the infants with gram negative septicemia had a platelet count below 150,000; 71% below 100,000 (average 67,000 septic babies, 257,000 non-septic babies). The drop in platelet count with gram negative septicemia was abrupt---as much as 222,000 in 24 hours. Platelets increased when therapy was effective. Two children with gram negative septicemia had platelet counts of 50,000 and 20,000. The platelet count for patients with gram positive septicemia was 299,000, and above 150,000 in all children with ruptured and non-ruptured appendicitis and major surgery without gram negative septicemia. It was concluded that serial measurements of platelet count in the postoperative infant and child was a rapid and reliable method for early detection of gram negative septicemia and changes in platelet count in response to treatment was an indicator of the effectiveness of therapy.
93名年龄在1天至13岁的术后患者接受了血培养、鲎试剂检测、纤维蛋白降解产物测定、白细胞和血小板计数。研究分为七组。在革兰氏阴性菌败血症患者中，鲎试剂检测常呈阳性（64%），但存在假阳性和假阴性情况。纤维蛋白降解产物检测结果不一致。革兰氏阴性菌败血症婴儿的白细胞计数较低。100%的革兰氏阴性菌败血症婴儿血小板计数低于150,000；71%低于100,000（败血症婴儿平均为67,000，非败血症婴儿为257,000）。革兰氏阴性菌败血症导致的血小板计数下降很突然——24小时内可下降多达222,000。治疗有效时血小板数量会增加。两名革兰氏阴性菌败血症患儿的血小板计数分别为50,000和20,000。革兰氏阳性菌败血症患者的血小板计数为299,000，所有阑尾炎破裂和未破裂以及无革兰氏阴性菌败血症的大手术患儿的血小板计数均高于150,000。得出的结论是，对术后婴幼儿进行血小板计数的连续测量是早期检测革兰氏阴性菌败血症的快速可靠方法，并且血小板计数随治疗的变化是治疗效果的一个指标。
