摘要
目的探讨脓毒症患儿凝血纤溶功能的变化及临床意义。方法符合脓毒症诊断标准的患儿,按小儿危重症评分分为非危重组、危重组、极危重组。于发病后1 d 清晨7:00静脉采血,用发色底物法测定纤溶酶原(plasminogen,PLG)活性,ELISA 法测定 D-二聚体(D-dimer,DD)含量。同时监测血小板计数(platelet,PLT)、凝血酶原时间(prothrombin test,PT)、部分凝血活酶时间(activated partial thromboplastin time,APTT)。结果危重组PLG 降低,DD 升高,极危重组 DD 高于危重组(P<0.01),PLG 低于危重组(P<0.05),危重组 DD 高于非危重组(P<0.01),PLG 低于非危重组(P<0.01)。极危重组活化 APTT、PT 长于危重组(P<0.05,P<0.01).危重组长于非危重组(P<0.01),极危重组 PLT 低于危重组及非危重组(P<0.01)。结论脓毒症患儿凝血系统紊乱普遍存在,包括促凝活性增加、纤溶系统抑制。监测 PLT、PT、APTT、DD、PLG 对病情估计和预后判断有一定临床意义。
Objective To observe the alteration of coagulation and fibrinolytic function in sepsis children, and evaluate the clinical significance. Methods A prospective case-control study was carried out in our PICU. The patients with sepsis were divided into no severe, severe, and critically severe groups. The intravenous blood samples were taken on the 1st day after admission to measure the plasma levels of D-dimer （ DD）, plasminogen （ PLG）, prothrombin test （PT）, activated partial thromboplastin time（APTT） and platelet（PLT） in all cases. Results PLG levels in severe group were lower and DD levels higher than those in no severe group（ P 〈0.01）. The changes in critically severe group are more evident than those in severe group. PT, APTT were significantly longer in critically severe group than those in severe ones. Levels of PT, APTT were also significantly longer in severe group than those in no severe ones. PLT were lower in severe and critically severe groups （P〈0.01 ）, and the latter was much lower （P 〈0.01 ）. Conclusion The blood coagulation disorder in sepsis patients was common. The coagulation were activated, and fibrionolysis was inhibited. Changes in coagulation and fibrinolysis parameters were important for evaluating the condition and prognosis of sepsis.
出处
《河北医科大学学报》
CAS
2009年第3期253-255,共3页
Journal of Hebei Medical University
基金
河北省科学技术研究与发展计划项目(052761115)
