脓毒症患儿抗凝血酶Ⅲ、D－二聚体与小儿危重评分的相关性

临床儿科杂志 ›› 2014, Vol. 32 ›› Issue (3): 224-227.

脓毒症患儿抗凝血酶Ⅲ、D－二聚体与小儿危重评分的相关性

齐英征

新疆医科大学第五附属医院儿科（新疆乌鲁木齐　830011）

收稿日期:2013-07-31 出版日期:2014-03-15 发布日期:2014-03-15

The relationships of antithrombin Ⅲ and D-dimer with pediatric critical illness score in children with sepsis　QI Yingzheng (Department of Pediatrics, The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang, China)　

Received:2013-07-31 Published:2014-03-15 Online:2014-03-15

摘要/Abstract

摘要：

　目的　探讨脓毒症患儿血浆抗凝血酶Ⅲ（AT-Ⅲ）、D-二聚体（DD）与小儿危重评分（PCIS）的关系及其对病情危重程度的判断价值。方法　回顾性分析61例脓毒症患儿在入院24 h内检测的血浆AT-Ⅲ和DD水平及PCIS评分等资料。将患儿按PCIS分为极危重组（≤70分）、危重组（71~80分）、非危重组（>80分）；将患儿按预后分为存活组和死亡组，分别比较AT-Ⅲ活性、DD水平的差异及其与PCIS的相关性。结果　极危重组、危重组和非危重组的AT-Ⅲ活性和DD水平的差异均有统计学意义（P<0.01）；其中，以极危重组AT-Ⅲ活性降低以及DD水平升高最为明显，危重组次之，两两比较差异均有统计学意义（P<0.05）。AT-Ⅲ活性与PCIS 评分呈正相关（r=0.548，P<0.01），DD水平与PCIS呈负相关（r=-0.657，P<0.01）。死亡患儿DD水平高于存活患儿，AT-Ⅲ活性和PCIS评分均低于存活患儿，差异均有统计学意义（P<0.05）。结论　脓毒症患儿存在明显的凝血功能障碍，血浆AT-Ⅲ、DD与其病情危重程度密切相关，可作为判断病情的指标。

Abstract: Objective To explore the relationships between antithrombin Ⅲ (AT-Ⅲ) and D-dimer (DD) level with pediatric critical illness score (PCIS) in children with sepsis, and to evaluate the values in assessing the severity of illness. Methods Sixty-one children with sepsis were included in this study. Within 24 hours after admission, blood samples were tested for the activity of AT-Ⅲ and DD level. The PCIS was calculated. According to PCIS, the patients were divided into extremely critical group (<70), critical group (71-80) and non-critical group (80-100). According to the prognosis, the patients were divided into survival and death groups. The differences of the activity of AT-Ⅲ and DD were compared and the relationship with PCIS were analyzed. Results The activity of AT-Ⅲ was lower and DD level was higher in critical group than in non-critical group (P<0.01) and the changes in extremely critical group were more evident than those in critical group. The activity of AT-Ⅲ and PCIS were positively correlated (r=0.548, P<0.01).The DD level and PCIS was negatively correlated (r=-0.657, P<0.01). Compared with survival group, the level of DD was significantly higher in death group (P<0.01), and PCIS and the activity of AT-Ⅲ were significantly lower in death group (P<0.05). Conclusions The patients with sepsis have dysfunctions of coagulation. The activity of AT-Ⅲ, DD level are correlated with illness severity, and can be useful for assessing the severity of sepsis.

齐英征. 脓毒症患儿抗凝血酶Ⅲ、D－二聚体与小儿危重评分的相关性[J]. 临床儿科杂志, 2014, 32(3): 224-227.

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