摘要
目的:探讨小儿脓毒症血浆D-二聚体、凝血酶原时间、凝血酶时间、活化部分凝血活酶时间、纤维蛋白原和血小板在小儿脓毒症不同病情阶段的变化,为防治小儿脓毒症提供理论依据。方法:重症监护室住院患儿51例为脓毒症组,同期本院普通病房患儿30例为普通感染组,健康小儿20例为对照组。对入选病例即时检测血浆D-二聚体、凝血酶原时间、凝血酶时间、活化部分凝血活酶时间、纤维蛋白原和血小板和24,48,72h病情评估。结果:(1)血浆D-二聚体在脓毒症组明显高于普通感染组(P<0.05),随病情加重而升高,与危重评分呈负相关(P<0.05?;(2)凝血酶原时间、凝血酶时间、活化部分凝血活酶时间在脓毒症组明显延长,纤维蛋白原、血小板明显降低(P<0.05),凝血酶原时间、凝血酶时间、活化部分凝血活酶时间、纤维蛋白原与危重评分及预后无相关性(P>0.05)。结论:血浆D-二聚体对诊断小儿脓毒症纤溶状态有一定的参考价值,动态观察小儿脓毒症凝血、纤溶变化,可为脓毒症早期治疗、判断预后提供一定的理论依据。
Objective To study the clinical significance of D-dimer, blood coagulation of prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen and platelet counts, and provide scientific reference for the treatment of sepsis in coagulopathy. Methods Fifty-one patients with sepsis in Intensive Critical Unit were collected in this study, 30 cases were ordinarily infected in general ward and 20 were healthy children. Homologous adjunctive examina ination was done according to the different disease. D-dimer, blood coagulation of prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen and platelet countswere detected immediately since patients were certified in our study. Results （1） The plasma D-dimer level of the sepsis group was higher. There was significant difference among the sepsis, severe sepsis and multiple organ dysfunction syndrome,it became much higher with the severe illness. There was a negative correlation between D-dimer and pediatric critical illness score. （2） It was longer of blood coagulation of prothrombin time, activated partial thromboplastin time, thrombin time and lower of fibrinogen, platelet counts in sepsis group. They were irrelative with pediatric critical illness score and prognosis. Conclusion The plasma D-dimer has certain value in the diagnosis of sepsis in fibrinolytic state. It can provide a theoretical basis by monitoring coagulation and fibrinolysis changes of sepsis in children for the early treatment and prognosis.
出处
《中华实用诊断与治疗杂志》
2008年第11期818-820,共3页
Journal of Chinese Practical Diagnosis and Therapy
