关键词: 金黄色葡萄球菌；　脓毒症；　凝血功能；　危险因素；　儿童

Abstract: Objective　To explore the effect of coagulation dysfunction on the prognosis of Staphylococcus aureus sepsis in children. Methods　The clinical data of Staphylococcus aureus sepsis in 130 children from January 2014 to February 2018 were analyzed retrospectively. According to the outcome, the patients were divided into survival group and death group. Univariate and multivariate logistic regression analysis were carried out, and ROC analysis was performed for related indicators of coagulation function. Results　In the 130 patients (68 boys; 62 girls) with a median age of 54.0 months (10.7~129.8 months), 34 died and case fatality rate was 26.2%. The detection rate of methicillin-resistant Staphylococcus aureus, procalcitonin, C-reactive protein, platelet distribution width, activated partial thromboplastin time, thrombin time, D-dimer level, the proportion of prothrombin time ≥17s in the death group were significantly higher than those in the survival group, and the platelet count and fibrinogen were significantly lower than those in the survival group (all P<0.05). Multivariate logistic regression analysis showed that primary blood flow infection, methicillin-resistant Staphylococcus aureus infection, prothrombin time (PT) extension, increased D-dimer and thrombocytopenia were independent risk factors for death (all P<0.05). When PT was 17s, D-dimer was 5.9 mg/L and platelet was 50×109/L, area under the ROC curve (AUC) was 0.853, 0.870 and 0.889, respectively. The sensitivity of predicting death was 88.24%, 88.24% and 52.94%, and the specificity was 83.33%, 83.33% and 97.92%, respectively. When combined the above three indicators of coagulation function, the ROC analysis showed that the sensitivity and specificity of predicting death were 85.29% and 94.79%, respectively, and the AUC was 0.936. Conclusions　When prothrombin time ≥17s, D-dimer ≥5.9 mg/L, platelets ≤50×109/L, the risk of death in children with Staphylococcus aureus sepsis increased, and the value of combination of three indicators to predict the death of children was higher.

Key words: Saphylococcus aureus;　sepsis;　coagulation function;　risk factor;　child