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Objective: We retrospectively analyzed 336 cases of critically ill patients with platelet parameter changes, changes in parameters of platelet-associated outcomes in critically ill patients the clinical significance, and its prognosis correlation analysis, in order to further provide a theoretical basis for clinical work. Methods: Statistics February 2009 -2011 in February ICU of our hospital critically ill patients admitted to 336 cases, 169 cases of male, female 167 cases, aged 17-106 years old, mean age 59.5 ± 15.4 years; study patients before admission except short history of a large loss of blood, blood disorders (such as idiopathic thrombocytopenic purpura, aplastic anemia), malignancy extreme consumption, cirrhosis of the liver, due to a variety of needs before admission, antiplatelet, anticoagulant drugs, hospitalization Over platelet transfusion shortly before or applied l-platelet drugs, poor compliance for various reasons, do not meet the inspection and clinics were. Critically ill patients admitted to the ICU in accordance with the first day of the auxiliary examination worst value APACHE Ⅱ score, patients were divided into three groups: A (APACHE Ⅱ score lt; 10 of 156 cases), B group (APACHE Ⅱ score 11 to 19 points 109 cases), C group (APACHE Ⅱ score gt; 20 minutes 71 cases), collecting patient age, history of chronic diseases and admission one day, better turn out ICU (discharge) or death that day the patient's body temperature, respiratory rate, heart rate, mean arterial pressure , Glasgow coma score, blood pressure, alveolar-arterial oxygen, pH, sodium, potassium, serum creatinine, hematocrit, white blood cell count, platelet count, mean platelet volume, platelet distribution width and the treatment effect ( condition improved or transferred out of the ICU discharge to survive in the ICU ward died during hospitalization or dying state to abandon the treatment of death), the application of statistical software to calculate the mortality rate among the groups, platelet count, mean platelet volume and platelet distribution width whether the differences ; while critically ill patients in accordance with the relevant parameters of platelet ICU admission and treatment is divided into normal or a, b, c, d group, a group: platelet-related parameters into the ICU, there is one or more of the final out of the normal range of clinical death patients 58 cases, b Group: ICU admission platelet-related parameters in one or more of the normal range is not the ultimate prognosis is good (better ICU discharge or discharge) in patients 82 cases, c Group: ICU admission platelet-related parameters were normal final 31 patients with clinical death, d Group: ICU admission were normal platelet-related parameters ultimately better prognosis (ICU discharge or discharge) of patients 165 cases. Statistics in each group of patients at ICU and improved transferred ICU (discharge) or death day APACHE Ⅱ score, platelet count, mean platelet volume, platelet distribution width changes without statistical significance. Results: 1. Disease severity and disease prognosis: A group survived 139 cases, 17 patients died, mortality 10.9%; B group survived 74 cases, 35 cases of death, mortality 32.1%; C group survived 34 cases, 37 cases of death, mortality of 52.1%. Mortality between the groups were significantly different (P lt; 0.05), APACHE Ⅱ score higher the value, the more severe the disease, the mortality rate is higher. (2) the severity of disease and the relationship between changes in platelet-related parameters: A group of platelet count was 159 ± 42 × 109 / L, mean platelet volume was 7.3 ± 2.2fl, platelet distribution width of 15.3 ± 3.1%, B group platelet count 126 ± 36x 109 / L, mean platelet volume was 8.5 ± 2.1fl, platelet distribution width of 16.4 ± 2.9%, C group platelet count was 96 ± 32 × 109 / L, mean platelet volume was 9.9 ± 2.3fl, platelet distribution width was 17.6 ± 3.5%. Comparative A, B, C 3 groups of patients platelet count, mean platelet volume, platelet distribution width are significantly different (P lt; 0.05), along with APACHE Ⅱ score values ??increased, platelet count, mean platelet volume increased, platelet distribution width increases. 3 platelet parameter changes the dynamic evolution and disease relationships: a group of patients at ICU admission APACHE Ⅱ score 19.5 ± 3.2, platelet count 94 30x 109 / L, mean platelet volume 9.8 ± 2.1fl, platelet distribution width of 17.4 ± 2.9% , died the same day APACHE Ⅱ score 24.3 ± 3.1, platelet count 49 ± 21 × 109 / L, mean platelet volume 11.1 ± 2.5fl, platelet distribution width 18.5 ± 2.8%, their death that day and into the ICU, compared APACHE Ⅱ score, mean platelet volume and significant increase in platelet distribution width, platelet count decreased, a significant difference (P lt; 0.05); b group of patients into the ICU when APACHE Ⅱ score 17.8 ± 2.9, platelet count 97 ± 30 × 109 / L, mean platelet volume of 9.3 ± 1.9 fl, platelet distribution width of 16.5 ± 2.5%, out of ICU day APACHE Ⅱ score 8.9 ± 2.1, platelet count 152 ± 35 × 109 / L, mean platelet volume 7.4 ± 1.8f1, platelet distribution width of 15.1 ± 1.9%, its day and out of ICU admission to the ICU when compared APACHE Ⅱ score, mean platelet volume and platelet distribution width decreased, platelet count increased significantly, a significant difference (P lt; 0.05); c group of patients into the ICU when APACHE Ⅱ score 16.7 ± 2.7, platelet count 125 ± 26 × 109 / L, mean platelet volume 8.9 ± 2.1fl, platelet distribution width of 15.3 ± 1.8%, died the same day APACHE Ⅱ score 22.6 ± 3.3, platelet count of 79 ± 28 × 109 / L, mean platelet volume 10.8 ± 2.4fl, platelet distribution width 17.6 ± 2.3%, their death that day and into the ICU, compared APACHE Ⅱ score, mean platelet volume and platelet distribution width was significantly increased, platelet count decreased, a significant difference (P lt; 0.05); d group of patients into the ICU when APACHE Ⅱ score 12.7 ± 2.7, platelet count 137 ± 37x 109 / L, mean platelet volume 8.5 ± 2.9fl, platelet distribution width of 15.7 ± 1.8%, out of ICU day APACHE Ⅱ score 8.1 ± 2.0, platelet count 167 ± 41 × 109 / L, mean platelet volume of 8.3 ± 2.5fl, platelet distribution width 15.4 ± 1.9%, its out of ICU ICU admission day compared with APACHE Ⅱ score significantly decreased, platelet count increased significantly, a significant difference (P lt; 0.05), mean platelet volume and platelet distribution Width No statistical differences (P gt; 0.05). These tips, along with changes in disease severity, platelet-related parameters also change accordingly. Conclusion: With the critically ill patient severity of disease severity, APACHE Ⅱ score values ??increased, which significantly reduced platelet count, mean platelet volume significantly increased, platelet distribution width significantly increased mortality also significantly increased. (2) platelet count, mean platelet volume and platelet distribution width and the prognosis of critically ill patients a significant correlation exists, namely platelet count less, mean platelet volume and platelet distribution width greater the greater the more severe the disease prompted the disease, the worse the prognosis On the contrary, the better the prognosis.
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