Difference cause analysis on thrombocytopenia by different bacterial infections in patients with sepsis

doi:10.3969/j.issn.1673-8640.2015.02.008

Abstract

Abstract: Objective

To analyze primarily the difference causes of thrombocytopenia by different bacterial infections in patients with sepsis, to distinguish the biochemical characteristics of Gram-positive bacteria (G⁺) and Gram-negative bacteria (G^-), and to provide the reference for the clinical early prevention of multiple organ failure and reduce the mortality rate.

Methods

A total of 155 sepsis patients, 56 patients with non-sepsis (infection group) and 43 non-infected controls were enrolled, and their platelet (PLT), procalcitonin (PCT), C reactive protein (CRP), white blood cell (WBC), the percentage of neutrophils (NE) and Bcl-xL protein levels were determined. The results were analyzed statistically. Blood culture was performed simultaneously, 75 cases of blood culture-positive sepsis patients were classified into G⁺ and G^- groups. Their PLT, PCT, Bcl-xL protein and different PCT cross-section percentages were analyzed.

Results

Biochemical parameters of sepsis group had obvious difference with those of control group (P<0.01). Compared with infection group, serum PLT, PCT, CRP and Bcl-xL protein levels were significantly different (P<0.01), and WBC and the percentage of NE had no statistical significance (P> 0.05). In infection group, PCT, CRP, WBC, NE percentage had statistical significance compared with those in control group (P<0.01), but the differences of PLT and Bcl-xL protein were not significant (P> 0.05). For G⁺ and G^- groups in sepsis patients, when PCT <2.0 ng/mL, there was no statistical significance (P>0.05). When 2.0 ng/mL≤PCT≤10.0 ng/mL, the percentage in G⁺ group was significantly higher than that in G^- group (P<0.01). When PCT ≥ 10.0 ng/mL, the percentage in G^- group was significantly higher than that in G⁺ group (P<0.01). PLT and PCT levels in G^- group were lower than those in G⁺ group (P<0.01).

Conclusions

The reduction of PLT and the increase of PCT are related to the apoptosis of PLT caused by Bcl-xL protein. G^- sepsis is easier to start PLT apoptosis than G⁺ sepsis with higher risk.

Key words: Sepsis, Thrombocytopenia, Bcl-xL protein

CLC Number:

R446.11

YAN Feng, REN Zhenhuan, ZHOU Ying. Difference cause analysis on thrombocytopenia by different bacterial infections in patients with sepsis[J]. Laboratory Medicine, 2015, 30(2): 137-140.

Figures/Tables 4

References 15

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组别	例数	PLT(×10⁹/L)	PCT (ng/mL)		CRP(mg/L)	WBC(×10⁹/L)	NE(%)	Bcl-xL(ng/mL)
脓毒症组	155	71±86^#*	14.5	±26.90^#*	105.1±66.2^#*	12.7±5.6^#	0.865±0.095^#	8.6±6.3^#
感染组	56	155±73	0.59	±0.34^#	39.4±55.0^#	11.8±5.0^#	0.882±0.050^#	21.8±9.5
对照组	43	176±95	0.12	±0.26	4.2±6.8	7.8±6.4	0.602±0.105	25.2±10.6

组别	例数	PLT(×10⁹/L)	PCT (ng/mL)		CRP(mg/L)	WBC(×10⁹/L)	NE(%)	Bcl-xL(ng/mL)
脓毒症组	155	71±86^#*	14.5	±26.90^#*	105.1±66.2^#*	12.7±5.6^#	0.865±0.095^#	8.6±6.3^#
感染组	56	155±73	0.59	±0.34^#	39.4±55.0^#	11.8±5.0^#	0.882±0.050^#	21.8±9.5
对照组	43	176±95	0.12	±0.26	4.2±6.8	7.8±6.4	0.602±0.105	25.2±10.6

组别	例数	PCT截值浓度(ng/mL)
组别	例数	<0.5	0.5≤PCT<2.0	2.0≤PCT≤10.0	≥10.0
G^-细菌脓毒症组	45	0(0.0)	2(4.4)	9(20.0)	34(75.6)^#
G⁺细菌脓毒症组	30	0(0.0)	1(3.3)	22(73.4)	7(23.3)
χ²			0.016	14.080	16.490
P值			>0.05	<0.01	<0.01

组别	例数	PCT截值浓度(ng/mL)
组别	例数	<0.5	0.5≤PCT<2.0	2.0≤PCT≤10.0	≥10.0
G^-细菌脓毒症组	45	0(0.0)	2(4.4)	9(20.0)	34(75.6)^#
G⁺细菌脓毒症组	30	0(0.0)	1(3.3)	22(73.4)	7(23.3)
χ²			0.016	14.080	16.490
P值			>0.05	<0.01	<0.01

组别	例数	PLT(×10⁹/L)	PCT(ng/mL)	Bcl-xL(ng/mL)
G^-细菌脓毒症组	45	61±73^*	16.3±33.5^*	7.5±6.3^*
G⁺细菌脓毒症组	30	93±65	9.2±25.6	10.2±3.5