纤维蛋白相关标志物对重症肺炎患儿DIC前状态的诊断价值

发布时间：2018-01-23 22:30

本文关键词： 重症肺炎纤维蛋白单体 D-二聚体儿童　出处：《临床儿科杂志》2016年08期 　论文类型：期刊论文

【摘要】：目的探讨纤维蛋白单体(FM)、D-二聚体(D-D)、纤维蛋白(原)降解产物(FDP)3种纤维蛋白相关标志物在重症肺炎患儿弥散性血管内凝血前状态(Pre-DIC)中的诊断价值。方法 213例重症肺炎患儿根据其是否合并Pre-DIC分为Pre-DIC组和病例对照组,另选择40例健康儿童作为正常对照组。分析各组的FM、D-D、FDP、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、血小板计数(PLT)、血栓调节蛋白(TM)水平,应用受试者工作特征曲线对各指标进行比较和评价。结果三组间除FIB外其余各指标差异均有统计学意义(P均0.05),其中FM、D-D、FDP、APTT三组间两两比较差异均有统计学意义(P均0.01),Pre-DIC组最高,病例对照组次之;Pre DIC组的PT明显高于正常对照组与病例对照组(P0.05),而后两组的PT差异无统计学意义(P0.05);Pre-DIC组和病例对照组的TM和PLT均高于正常对照组(P0.01),但前两组的差异均无统计学意义(P0.05)。各指标中FM、D-D、FDP诊断重症肺炎患儿DIC前状态的曲线下面积较大,分别为0.84、0.76、0.64,三者联合诊断时曲线下面积为0.85。结论纤维蛋白相关标志物FM、D-D、FDP可作为重症肺炎患儿Pre-DIC诊断中有价值的标志物,3项联合检测可提高诊断准确性。
[Abstract]:Objective to study the D-D of fibrin monomers FMN D- dimer (D-D). Fibrin degradation products and three Fibrin-related markers in PreDICs of disseminated Intravascular Coagulation in Children with severe pneumonia. Methods 213 children with severe pneumonia were divided into Pre-DIC group and case control group according to whether they were complicated with Pre-DIC. Another 40 healthy children were selected as normal control group. The levels of FMND-DV FDP, prothrombin time (PTT) and activated partial thromboplastin time (APTT) were analyzed. Fibrinogen FIBN, platelet count and thrombomodulin (TMN) levels. Results there were significant differences among the three groups except FIB (P < 0.05). The differences among the three groups were statistically significant (P < 0.01), followed by the case control group (P < 0.01). PT in Pre DIC group was significantly higher than that in normal control group and case control group (P 0.05), but there was no significant difference in PT between the latter two groups. TM and PLT in Pre-DIC group and case control group were higher than that in normal control group (P 0.01), but there was no significant difference between the former two groups (P 0.05). The area under the curve of FDP in the diagnosis of severe pneumonia in children before DIC was 0.840.76 卤0.64, respectively. The area under the curve is 0.85.ConclusionFDP can be used as a valuable marker in the diagnosis of Pre-DIC in children with severe pneumonia. Three combined tests can improve the diagnostic accuracy.
【作者单位】：湖南省儿童医院检验科;
【基金】：湖南省卫生和计划生育委员会应用研究项目(No.B2015-127)
【分类号】：R725.6;R446.1
【正文快照】： 儿童重症肺炎容易诱发凝血功能障碍和弥散性血管内凝血(disseminated intravascular coagulation,DIC)[1-3],而DIC是导致重症肺炎患儿死亡的重要原因,由于其临床表现无特异性,容易被忽视而加重病情。因此重症肺炎患儿DIC早期状态即DIC前状态(PreDIC)的发现和诊断并及时采取

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