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目的探讨不同细菌感染致脓毒症患者血小板减少差异的原因。方法选取155例脓毒血症患者[根据感染类型又分为G-细菌感染组(n=75)和G+细菌感染组(n=80)]、非脓毒血症患者56例及非感染对照43例,检测三组患者血小板计数(PLT)、降钙素原(PCT)、C-反应蛋白(CRP)、白细胞(WBC)、中性粒细胞(NE)百分比及Bcl-xl蛋白水平。结果脓毒症组PLT、Bcl-xl指标低于非脓毒症组和非感染对照组(P<0.05),而PCT、CRP、WBC计数、NE高于非脓毒症组和非感染对照组(P<0.05)。脓毒症G-细菌感染组PLT、Bcl-xl水平低于G+细菌感染组(P<0.05),而PCT水平高于G+细菌感染组(P<0.05)。结论脓毒血症患者出现PLT降低、PCT升高现象,与Bcl-xl启动PLT凋亡程序有关;且革兰阳性菌更容易启动PLT凋亡,危险性更高。
Objective To investigate the causes of thrombocytopenia in patients with sepsis caused by different bacterial infections. Methods A total of 155 patients with sepsis [divided into G-bacterial infection group (n = 75) and G + bacterial infection group (n = 80) according to the type of infection] were enrolled. Fifty-six non-sepsis patients and non-infected control Forty-three patients were enrolled in this study. PLT, PCT, CRP, WBC, neutrophil (NE) percentage and Bcl-xl protein level were measured in three groups. Results The indexes of PLT and Bcl-xl in sepsis group were lower than that in non-sepsis group and non-infected control group (P <0.05), while PCT, CRP and WBC count were higher than those in non-sepsis group and non-infected control group (P <0.05). The levels of PLT and Bcl-xl in septic G-bacterial infection group were lower than those in G + bacterial infection group (P <0.05), while PCT levels were higher than those in G + bacterial infection group (P <0.05). Conclusions PLT decreased and PCT increased in patients with sepsis, which is related to Bcl-xl activation of PLT apoptosis program. Gram-positive bacteria are more likely to initiate apoptosis of PLT with higher risk.