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Objective:To investigate the predictive value of the maximum aggregation rate (MAR) of platelet for septic shock and septic shock with disseminated intravascular coagulation (DIC).Methods:A retrospective case-control study enrolled patients with sepsis admitted to department of critical care medicine of the First Affiliated Hospital of Zhengzhou University from January 2021 to November 2022. The basic data, dynamic platelet aggregation rate, blood routine, inflammation indicators, sequential organ failure assessment (SOFA) and other clinical indicators within 24 hours after admission were collected. Septic patients were divided into the shock group and the non-shock group according to the presence of septic shock; then refer to the International Society on Thrombosis and Hemostasis (ISTH) standard, patients with septic shock were divided into the shock DIC group and the shock non-DIC group according to the presence of dominant DIC. Compared the differences in platelet aggregation function between these groups, and the receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive value of the MAR for septic shock and septic shock with DIC. Spearman correlation analysis was used to analyze the correlation of MAR with inflammation indicators and the severity of illness in patients with sepsis.Results:A total of 153 sepsis patients were included and 61 with septic shock (including 17 with dominant DIC and 44 without dominant DIC). Compared with the non-shock group, the level of procalcitonin (PCT), C-reactive protein (CRP), and SOFA score were significantly higher in the shock group [PCT (mg/L): 6.90 (2.50, 23.50) vs. 0.87 (0.26, 5.75), CRP (mg/L): 156.48 (67.11, 230.84) vs. 90.39 (46.43, 182.76), SOFA score: 11.00 (8.00, 14.00) vs. 5.00 (3.00, 8.00), all P < 0.05]. The platelet count (PLT) and the MAR induced by adenosine diphosphate (ADP), adrenaline (A), collagen (COL), and arachidonic acid (AA; ADP-MAR, A-MAR, COL-MAR, AA-MAR) in the shock group were significantly decreased [PLT (×10 9/L): 101.00 (49.00, 163.50) vs. 175.50 (108.25, 254.50), ADP-MAR: 28.50% (22.00%, 38.05%) vs. 45.90% (33.98%, 60.28%), A-MAR: 38.90% (30.00%, 55.40%) vs. 65.15% (54.38%, 72.53%), COL-MAR: 27.90% (20.85%, 36.55%) vs. 42.95% (33.73%, 54.08%), AA-MAR: 24.70% (16.40%, 34.20%) vs. 46.55% (28.33%, 59.20%), all P < 0.05]. Subgroup analysis revealed that, compared with the shock non-DIC group, the SOFA scores were significantly higher in patients in the shock DIC group (13.29±5.23 vs. 10.39±3.58, P < 0.05), the PLT and COL-MAR in the shock DIC group were significantly reduced [PLT (×10 9/L): 36.00 (22.00, 67.50) vs. 115.50 (84.25, 203.75), COL-MAR: 21.50% (17.85%, 32.60%) vs. 30.95% (22.98%, 38.53%), all P < 0.05]. ROC curve analysis showed that A-MAR had a higher predictive value for septic shock, and the area under the ROC curve (AUC) was 0.814 [95% confidence interval (95% CI) was 0.742-0.886, P = 0.000]. When the optimal cut-off value was 51.35%, the sensitivity was 68.9%, the specificity was 82.6%, the positive predictive value was 0.724 and the negative predictive value was 0.800. COL-MAR had some predictive value for septic shock with DIC, and the AUC was 0.668 (95% CI was 0.513-0.823, P = 0.044). When the optimal cut-off value was 21.90%, the sensitivity was 52.9%, the specificity was 79.5%, the positive predictive value was 0.500, and the negative predictive value was 0.813. Spearman correlation analysis showed that the MAR induced by each inducer was negatively correlated with inflammatory indicators and SOFA scores in sepsis patients, with A-MAR showing the strongest correlation with SOFA score ( r = -0.327, P = 0.000). Conclusions:MAR, an indicator of platelet aggregation function, shows predictive value for septic shock and septic shock with DIC, and it could be used to for evaluating the severity of patients with sepsis. In addition, tt alsocan be used as a monitoring index to predict the changes of sepsis patients and to guide the treatment.
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Objective To investigate the effect of Fuxin tablet on thrombus formation in the arteries in rats and aggregation of platelet in rabbits. Methods To observe the effect of OT in the arteries through electric stimulation of common carotid artery. To observe the aggregation of platelet by using the PRP of the rabbit and ADP as the accelerant. PAG-1, PAG-3, PAG-5 and PAG-M were examined in the normal saline group and high-dose, middle-dose, low-dose groups of Fuxin tablet. Results High-dose and middle-dose groups of Fuxin tablet could prolong OT and decrease the aggregation of platelet. Conclusion Fuxin tablet could significantly inhibit the formation of thrombus in the arteries and maximal aggregation rate of platelet.
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Objective To investigate the effect of combined antiplatelet drugs on clinic and aggregation activity of platelet in patient with aucte myocardial infarction(AMI).Methods Consecutive 97 cases with AMI were redomized to receive clopidogrel plus aspirin(treated group,n=48) or aspirin alone(placebo group,n=49) for 30 days.Before and after treatment,the clinical recurrent angina,improvement of heart function,death,ST segment changes of electrocardiogram and the rate of maximun aggregation of paltelet were tested and analysed.Results Recurrent angina occurred in 10.0%(5 cases) in the treated group and 20%(10 cases) in the placebo group.The total frequency of improvement of heart function occurred in 36.7%(18 cases) in the treated group and 22.4%(11 cases) in the placebo group(?~2=3.638,P=0.045).Death occurred in 4%(2 cases) in the treated group and 8%(4 cases) in the placebo group.ST segment of electrocardiogram decreased from (0.36?0.13)mV to (0.13?0.08)mV,compared with placebo from (0.35?0.14)mV to (0.16?0.90)mV(t=3.012,P=0.04).The rate of maximum aggregation of platelet induced by ADP reduced from (74.54?8.99)% to (34.09?9.23)%,the placebo from (72.30?7.78)% to (56.54?6.92)%(t=13.42,P