临床儿科杂志 ›› 2015, Vol. 33 ›› Issue (1): 20-.doi: 10.3969 j.issn.1000-3606.2015.01.006

• 危重症专栏 • 上一篇    下一篇

儿童重症肺炎凝血指标与降钙素原变化及分析

黄彩芝,莫丽亚,李爱国,杨娟,邓永超   

  1. 湖南省儿童医院( 湖南长沙410007)
  • 收稿日期:2015-01-15 出版日期:2015-01-15 发布日期:2015-01-15
  • 通讯作者: 黄彩芝 E-mail:hncshcz@163.com

The change of coagulation indicators and procalcitonin in children with severe pneumonia

HUANG Caizhi, MO Liya, LI Aiguo, YANG Juan, DENG Yongchao   

  1. Hunan Children’s Hospital, Changsha 410007, Hunan, China
  • Received:2015-01-15 Online:2015-01-15 Published:2015-01-15

摘要: 目的 探讨重症肺炎患儿凝血指标与降钙素原(PCT)的变化。方法 选取重症肺炎患儿76例,根据PCT升高的程度分为2组,PCT<2.00 ng/ml组和PCT≥2.00 ng/ml组;另选择30例健康儿童作为正常对照组。检测并分析比较各组的PCT、血小板计数(PLT)、抗凝血酶Ⅲ(AT-Ⅲ)活性和D-二聚体(DD)水平。结果 与对照组比较,重症肺炎组PCT、PLT、DD水平明显升高,AT-Ⅲ活性明显降低,差异均有统计学意义(P<0.05);PCT≥2.00 ng/ml组的AT-Ⅲ活性和PLT水平相比PCT<2.00 ng/ml组更低,而DD水平更高,差异均有统计学意义(P<0.05);PCT≥2.00 ng/ml组的DIC发生率(33.33%)高于PCT<2.00 ng/ml组(9.09%),差异有统计学意义(校正χ2=5.02,P=0.025)。 结论 重症肺炎患儿易发生凝血纤溶功能障碍,PCT水平越高,凝血纤溶功能紊乱越明显,越容易并发弥散性血管内凝血。

Abstract: Objective To explore the changes in the levels of coagulation indicators and procalcitonin (PCT) in children with severe pneumonia. Methods A total of 76 children with severe pneumonia were selected and were divided into two groups according to the level of PCT, PCT<2.00 ng/ml group and PCT ≥ 2.00 ng/ml group. Thirty healthy children were selected as normal controls. The levels of PCT, platelet counts (PLT), antithrombin- Ⅲ (AT- Ⅲ ) activity and D-dimer (DD) were measured and compared among groups. Results Compared with control group, PCT, PLT and DD levels were significantly higher and AT- Ⅲ activity was significantly lower in severe pneumonia group (P<0.05). AT- Ⅲ activity and PLT were significantly lower and DD level was significantly higher in PCT≥2.00 ng/ml group than those in PCT<2.00 ng/ml group (P<0.05). The incidence of disseminated intravascular coagulation (DIC) in PCT≥2.00ng/ml group was significantly higher than that in PCT<2.00ng/ml group (33.33% vs. 9.09%, corrected χ2=5.02, P=0.025). Conclusions There is dysfunction of coagulation in children with severe pneumonia. The higher level of PCT is, more obvious coagulation dysfunction is. The severe pneumonia children with high level of PCT are more likely to be complicated with disseminated inravascular coagulation.