Predictive efficacy of platelet,fibrinogen to C-reactive protein ratio in sepsis complicated with diffuse intravascular coagulation and their interaction with disseminated intravascular coagulation
Objective To analyze the efficacy of platelet(PLT),the ratio of fibrinogen to C-reactive protein(FIB/CRP)in predicting sepsis complicated with diffuse intravascular coagulation(DIC)and their interaction with DIC.Methods According to whether concurrent DIC,88 sepsis patients were divided into DIC group(32 cases)and non-DIC group(56 cases).General clinical data,laboratory results,FIB/CRP,acute physiology and chronic health status scoring system(APACHE)Ⅱ score,sequential organ failure assessment(SOFA)score and DIC score were compared between the two groups.According to PLT count,all patients were divided into PLT reduction group(51 cases)and PLT normal group(37 cases).LASSO regression was used to screen the influencing factors of sepsis complicated with DIC.Multivariate logistic regression analysis was used to investigate the influencing factors of sepsis complicated with DIC.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of relevant indicators in sepsis complicated with DIC.Interaction coefficient γ and odds ratio(OR)were used to analyze the existence and types of PLT,FIB/CRP interactions.Results CRP,APACHE Ⅱ score,SOFA score,DIC score,international standardized ratio(INR),D-dimer,prothrombin time(PT)and activated partial thromboplastin time(APTT)in DIC group were all higher than those in non-DIC group,antithrombin(AT),FIB,PLT count,FIB/CRP and DIC score were all lower than those in non-DIC group(P＜0.05).Multivariate logistic regression analysis showed that PLT count and FIB/CRP were independent influencing factors for sepsis complicated with DIC(P＜0.05).ROC curve analysis showed that the combined prediction of PLT and FIB/CRP for sepsis complicated with DIC was higher than that of PLT and FIB/CRP alone(P＜0.05).FIB/CRP in PLT reduced group patients was lower than that in PLT normal group(P＜0.001).PLT reduction had a positive interaction on FIB/CRP reduction,and their interaction conforms to the supermultiplicative model.Conclusion PLT,FIB/CRP are independent influencing factors of sepsis complicated with DIC,which can be used to predict the risk of sepsis complicated with DIC early in clinic,so as to carry out follow-up treatment and reduce the incidence of DIC.
SepsisDisseminated intravascular coagulationPlateletsFibrinogenC-reactive proteinPredictive value
万方数据
维普
