Objective: To study the clinical significance of the variance of platelets in systemic inflammatory response syndrome(SIRS) of critical illness.
Methods: Two hundred and thirteen critically ill patients in ICU, who suffered from SIRS, sepsis and multiple organ dysfunction syndrome (MODS), were enrolled in this study and divided into two groups, survivor group (n=151) and non-survivor group (n=62). Platelet, white blood cell counts and acute physiology and chronic health evaluation II (APACHE II) score were performed immediately after hospitalization, 3 days, 7 days, and 10 days later. At the same time, the serum was collected and the level of tumor necrosis factor-alpha (TNF-alpha) was measured.
Results: APACHE II score was much higher, but no difference in the two groups immediately after the hospitalization. However, it increased markedly in non-survivor group, and lowered dramatically in survivor group 7 days after therapy. There was a significant difference between the two groups (P<0.01). Platelets were slightly lower in both groups immediately after the hospitalization. After three days' therapy, it increased to the normal range in the two groups. However, it progressively dropped in non-survivor group 7 days and 10 days later, and it was significantly different from survivor group (P<0.001). The white blood cell counts revealed that there was no significant difference between the two groups. The level of TNF-alpha in serum was much higher in both groups immediately after the hospitalization. After three days' therapy, it further increased and was maintained at the high level in the two groups. However, it progressively dropped in survivor group, while it remained in higher level in non-survivor group 7 days and 10 days later, which was significantly different from survivor group (both P<0.001).
Conclusion: Refractory thrombocytopenia is sensitively responsive to poor prognosis and severity of SIRS in critical illness.
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