摘要
目的探究3种不同程度肺炎(普通肺炎、危重肺炎和极危重肺炎)患儿凝血功能指标的变化,为临床病情评估提供价值型参考。方法选取我院收治的普通肺炎、危重肺炎和极危重肺炎患儿320例,其中普通肺炎患儿182例,危重肺炎患儿91例,极危重肺炎患儿47例,所有患儿入院24 h内抽血送检,分析比较各组的凝血功能、血浆D-二聚体(D-dimer,D-D)、血小板等指标,并与小儿危重评分进行相关分析。结果危重肺炎组和极危重肺炎组凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、纤维蛋白原(fibrinogen,FIB)、纤维蛋白降解产物(fibrinogen degradation products,FDP)、D-D均高于普通肺炎组(P<0.05),极危重肺炎组FDP、D-D高于危重肺炎组(P<0.05),极危重肺炎组与危重肺炎组PT、APTT、FIB差异均无统计学意义(P>0.05)。危重肺炎组和极危重肺炎组PLT计数低于普通肺炎组,极危重肺炎组低于危重肺炎组(P<0.05),3组血小板平均体积(mean platelet volume,MPV)和血小板分布宽度(platelet distribution width,PDW)差异无统计学意义(P>0.05)。PLT计数、FIB、FDP及D-D对小儿危重病例评分有显著相关性,其中PLT与评分成显著正相关,而FIB、FDP及D-D与评分成显著负相关(P<0.05)。结论3种不同程度肺炎的凝血功能指标存在明显的差异,其中PLT、FIB、FDP、D-D等指标能够有效判断重症肺炎患儿的严重程度,对于临床医师选择和合理的治疗方案、提高治愈率、改善预后有重要临床意义。
Objective To explore the changes of coagulation function indexes in children with pneumonia of different severity(common pneumonia,critical pneumonia and extremely critical pneumonia),so as to provide a valuable reference for clinical evaluation of the disease.Methods A total of 320 children with common pneumonia,critical pneumonia and extremely critical pneumonia who were admitted to our hospital were enrolled in this study.Among them,there were 182 cases of common pneumonia,91 cases of critical pneumonia and 47 cases of extremely critical pneumonia.Blood was drawn from all children within 24 h after admission,and the coagulation function,plasma D-dimer(D-D),platelet and other indicators of each group were analyzed and compared.In addition,the correlation of these indicators with pediatric critical illness score(PCIS)was analyzed.Results Prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),fibrinogen degradation products(FDP)and D-D were higher in critical pheumonia group and extremely critical group than in common pneumonia group(P<0.05),and FDP and D-D in extremely critical pneumonia group were higher than those in critical pneumonia group(P<0.05).No significant difference was found in PT,APTT and FIB in extremely critical pneumonia group and critical pneumonia group(P>0.05).PLT count in critical pneumonia group and extremely critical pneumonia group was lower than that in common pneumonia group,which was lower in extremely critical pneumonia group than in critical pneumonia group(P<0.05).There was no significant difference in mean platelet volume(MPV)and platelet distribution width(PDW)among three groups(P>0.05).PLT count,FIB,FDP and D-D were significantly correlated with PCIS.PLT was significantly and positively correlated with the PCIS,while FIB,FDP and D-D were significantly and negatively correlated with the PCIS(P<0.05).Conclusion There are significant differences in the coagulation function indexes among three types of pneumonia of different severity.Among them,PLT,FIB,FDP,and D-D can effectively judge the severity of children with critical pneumonia,which is of great clinical significance for clinicians to choose a reasonable treatment scheme,and improve the cure rate and the prognosis of children with critical pneumonia.
作者
郭靖
郝明明
刘亚楠
闫平
殷站茹
GUO Jing;HAO Ming-ming;LIU Ya-nan;YAN Ping;YIN Zhan-ru(Department of Pediatrics, People′s Hospital of Hengshui City, Hebei Province,Hengshui 053000, China)
出处
《河北医科大学学报》
CAS
2021年第2期167-171,共5页
Journal of Hebei Medical University
基金
河北省医学研究课题计划(20191776)。
关键词
肺炎
小儿
凝血功能
pneumonia
children
blood coagulation function
