Department of Hematology, Shenzhen Hospital of Southern Medical University, Shenzhen, China.
Department of Hematology, Xiangya Third Hospital, Central South University, Changsha, China.
Ann Palliat Med. 2020 May;9(3):847-857. doi: 10.21037/apm.2020.04.12.
Multiple organ failure complicated by coagulation dysfunction is an important cause of death in patients with sepsis. This study aimed to explore the clinical significance of platelet maximum aggregation rate (MAR) in patients with sepsis and explored the relationship between MAR and prognosis to support treatment decision-making.
Blood samples from patients with sepsis (diagnosed according to the 2016 international diagnostic criteria for sepsis 3.0) treated between Sep 2017 and Apr 2018 were assessed. Patients were excluded if they had any other condition or treatment that may have affected platelet function in the previous 2 weeks. A control group of healthy subjects attending the physical examination center in the same period was also included. The MAR was measured using a whole blood platelet function analyzer (PL-12) using a range of different inducers of platelet aggregation, and normal saline. MAR was assessed in the healthy and septic groups, and survivors and non-survivors were compared in the sepsis group 28 days after treatment.
The MAR in the sepsis group was significantly lower than that seen in the healthy group (P<0.05 for all inducers). The MAR of patients with sepsis was negatively correlated with their Sequential Organ Failure Assessment (SOFA) scores. In the sepsis group, the MAR of non-survivors was significantly lower than that of the survivors (P<0.05 for all inducers).
The platelet MAR was significantly decreased in patients with sepsis and in non-survivors. These data may support treatment decision-making in patients with sepsis.
合并凝血功能障碍的多器官衰竭是脓毒症患者死亡的重要原因。本研究旨在探讨血小板最大聚集率(MAR)在脓毒症患者中的临床意义,并探讨 MAR 与预后的关系,为治疗决策提供支持。
评估了 2017 年 9 月至 2018 年 4 月期间收治的脓毒症患者(根据 2016 年国际脓毒症诊断标准 3.0 诊断)的血液样本。排除在过去 2 周内有任何其他可能影响血小板功能的疾病或治疗的患者。同时还纳入了同期在体检中心就诊的健康对照组。使用全血血小板功能分析仪(PL-12),使用一系列不同的血小板聚集诱导剂和生理盐水来测量 MAR。评估健康组和脓毒症组的 MAR,并在治疗后 28 天比较脓毒症组中存活者和非存活者的 MAR。
脓毒症组的 MAR 明显低于健康组(所有诱导剂均 P<0.05)。脓毒症患者的 MAR 与序贯器官衰竭评估(SOFA)评分呈负相关。在脓毒症组中,非存活者的 MAR 明显低于存活者(所有诱导剂均 P<0.05)。
脓毒症患者和非存活者的血小板 MAR 明显降低。这些数据可能支持脓毒症患者的治疗决策。