摘要
目的:探究血栓弹力图(TEG)参数结合降钙素原水平检测对肺炎患儿病情严重程度及抗感染治疗疗效的评估效能。方法:以2019-03—2020-05治疗的60例肺炎患儿作为研究对象,其中轻型患儿38例,重症患儿22例,根据患儿的治疗效果分组,显效患儿18例,有效患儿31例,无效患儿11例,比较不同严重程度患儿以及不同预后患儿TEG检测的指标以及降钙素原(PCT)之间的差异。分析患儿的疗效以及疾病严重程度与TEG检测的指标以及PCT相关性,探究患儿的CI指数以及PCT对疾病的严重程度以及治疗预后的评估价值。结果:轻型组患儿的R、MA、CI水平显著高于重症组,K、α、PCT水平显著低于重症组,差异有统计学意义(P<0.05);随着患儿的疗效升高,患儿的R、MA、CI水平显著升高,患儿的K、α、PCT水平显著下降;患儿的治疗效果分别与R(r=0.336,P=0.000)、MA(r=0.441,P=0.000)、CI(r=0.521,P=0.000)水平呈正相关,与K(r=0.445,P=0.000)、α(r=0.512,P=0.000)、PCT(r=0.528,P=0.000)水平呈负相关,患儿的疾病严重程度与R(r=0.236,P=0.000)、MA(r=0.552,P=0.000)、CI水平(r=0.514,P=0.000)呈负相关,与K(r=0.489,P=0.000)、α(r=0.547,P=0.000)、PCT(r=0.661,P=0.000)水平呈正相关;针对小儿肺炎患儿的疾病严重程度的分析中,重症患儿的CI指数以及PCT的临界值分别为1.85 ng/mL,2.33 ng/mL。而在对患儿的治疗中,无效患儿的CI指数以及PCT的临界值分别为2.09 ng/mL,1.11 ng/mL。结论:TEG参数通过对凝血功能的分析,同时结合降钙素对生存期的有效评估,对于患儿病情严重程度及抗感染治疗疗效的评估具有积极的作用,建议临床推广。
Objective:To explore the evaluation effect of TEG parameters combined with procalcitonin level on the severity of pneumonia and the efficacy of anti infection treatment.Method:In this study,60 children with pneumonia treated in our hospitalt fom March 2019 to May 2020 were selected as the research objects,including 38 children with mild pneumonia and 22 children with severe pneumonia.According to the treatment effect of the children,18 children with significant effect,31 children with effective effect and 11 children with ineffective effect were divided into groups.The differences of TEG detection indexes and PCT between children with different severity and prognosis were compared.The curative effect of children and the correlation between disease severity and TEG and PCT were analyzed,and the value of the CI index and PCT of children on disease severity and treatment prognosis were explored.Result:The levels of R,Ma and CI in the mlid group were significantly higher than those in the severe group,and the levels of K,α and PCT were significantly lower than those in the severe group(P<0.05).With the increase of the curative effect,the R,Ma and CI levels of the children increased significantly,and the K,αand PCT levels of the children decreased significantly;the therapeutic effects of the children were positively correlated with the levels of R(r=0.336,P=0.000),MA(r=0.441,P=0.000),CI(r=0.521,P=0.000),and negatively correlated with K(r=0.445,P=0.000),α(r=0.512,P=0.000),and PCT(r=0.528,P=0.000).The disease severity was negatively correlated with R(r=0.236,P=0.000),MA(r=0.552,P=0.000),CI(r=0.514,P=0.000),and positively correlated with K(r=0.489,P=0.000),α(r=0.547,P=0.000),and PCT(r=0.661,P=0.000).The critical values of CI and PCT of severe children were 1.85 and 2.33 ng/mL,respectively.The critical values of CI and PCT of ineffective children were 2.09 and 1.11 ng/mL,respectively.Conclusion:Analysis of coagulation function by TEG parameters,combined with the effective evaluation of calcitonin on the survival period,might have a positive effect on the evaluation of the severity of children’s disease and the efficacy of anti infective treatment,which would be recommended to promote in clinical.
作者
叶剑
李勇
吉山宝
诸澎伟
曹梅
杨元华
吴峤微
YE Jian;LI Yong;JI Shanbao;ZHU Pengwei;CAO Mei;YANG Yuanhua;WU Qiaowei(Intensive Care Unit,Wuxi Children's Hospital,Wuxi,214005,China)
出处
《临床血液学杂志（输血与检验）》
CAS
2020年第5期685-689,共5页
Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)
基金
无锡市卫生计生委妇幼健康科研项目(No:FYKY201702)。
关键词
肺炎
血栓弹力图参数
降钙素原
pneumonia
thromboelastography parameters
procalcitonin
