重度烧伤病人血小板参数变化及影响因素分析

Changes in platelet parameters and their influencing factors for patients with severe burn

摘要:

目的：观察重度烧伤病人血小板（Platelet，PLT）计数、PLT平均容积（Mean platelet volume，MPV）、PLT分布宽度（Platelet distribution width，PDW）的变化，探讨引起变化的影响因素。方法：烧伤后24 h测定烧伤病人PLT计数、MPV、PDW值，采用单因素分析方法分析这些参数与烧伤程度的关系；测定可能引起PLT计数改变的因素（烧伤总面积、Ⅲ度烧伤面积、接受成分输血、切削痂手术面积、生长激素应用等），采用Logistic回归分析方法分析影响PLT计数早期恢复正常的因素。结果：①烧伤后24 h测定PLT参数，健康对照组PLT计数均明显高于其他两组（P<0.05），MPV和PDW均明显低于其他两组（P<0.05）；重度烧伤组PLT计数，MPV和PDW均明显低于中轻度烧伤组（P<0.05）；②Logistic回归分析结果显示烧伤总面积和静滴乌丝他汀治疗均是疗后PLT计数早期恢复正常的保护因素。其中烧伤总面积约小，越有利于疗后PLT计数恢复正常范围；静滴乌丝他汀治疗有利于疗后PLT计数恢复正常范围。结论：重度烧伤病人伤后24 h的PLT计数、PDW、MPV均有明显改变，积极有效的治疗方法可以逆转病情。

Abstract:

Objective：To observe the changes in platelet（PLT） count，mean platelet volume（MPV） and platelet distribution width （PDW） in patients with severe burn and to explore their influencing factors. Methods：Changes of PLT count，MPV，and PDW were de－termined in 65 patients with severe burn. The relationship between these parameters and degree of burn was analyzed by single-factor analysis. The possible inducing factors of PLT count changes（total burned area，Ⅲ degree burn area，acceptance of component trans－fusion，cutting the scab area，using growth hormone，etc） were detected. Logistic regression was used to analyze the factor causing PLT count back to normal. Results：①The value of PLT count measured at 24 h after the burn was much higher in healthy control group than in the other two groups（P<0.05） while the values of MPV and PDW were much lower in healthy control group than in the other two groups（P<0.05）. There were significant differences in PLT count，MPV，and PDW between severe burn group and moderate burn group（P<0.05）. ②The results of Logistic regression analysis showed that total burned area and intravenous drip of Ulinastatin were factors that cause PLT count back to normal after the treatment. Conclusions：There are obvious changes in the values of PLT count，PDW，and MPV of patients with severe burn at 24 h post burn. Positive and effective treatment can reverse the condition.