凝血指标在婴幼儿重症肺炎中的变化及分析
发布时间：2019-05-10 07:42
【摘要】：目的通过检测重症肺炎患儿常见的能反映凝血功能的相关指标,总结重症肺炎患儿的凝血指标的变化和特点,评估重症肺炎患儿的凝血状态;同时分析各凝血指标与小儿危重病例评分(PCIS)在评估重症肺炎患儿病情中的相关性;以期为早期识别危重患儿,为及时干预提供理论依据。方法随机选取2015年10月到2016年10月在延安大学附属医院儿科住院的肺炎患儿,根据病情分为普通肺炎组(30例)及重症肺炎组(30例),并同期选取一般条件匹配的健康儿童作为对照组检测凝血系列(包括PT、APTT、FIB、FDP、D-D)及血小板参数(包括PLT、MPV)进行比较;对入选的重症肺炎患儿进行PCIS评分,按得分结果分为极危重组(≤70分)、危重组(71~80分)及非危重组(80分),比较各组凝血指标的变化及DIC的发生率;分析凝血指标与PCIS的相关性。结果1.重症肺炎组、普通肺炎组与正常对照组儿童的年龄、性别及体重的组间比较均无统计学意义(P0.05),差异不明显。2.肺炎组与对照组凝血指标的比较,除MPV外,余各指标水平在重症肺炎组、普通肺炎组及对照组中差异有统计学意义(P0.05),差异明显;普通肺炎组APTT、FIB及D-D较对照组比较有统计学意义(P0.017),差异明显;余各指标在在两组间差异均无统计学意义(P0.017),变化不明显。3.重症肺炎组与普通肺炎组相关凝血指标异常率的比较,重症肺炎组较普通肺炎组除外MPV余各指标的差异率比较有统计学意义(P0.05),重症肺炎组指标的差异率较普通肺炎组升高明显。4.极危重组、危重组及非危重组各凝血指标的比较,PLT在三组中比较有统计学意义(P0.05),PLT在极危重组较其他两组降低明显;PLT、APTT在危重组和非危重组之间差异无统计学意义(P0.017),PT、FIB及D-D在危重组与极危重组之间差异无统计学意义(P0.017);各组之间MPV比较无统计学意义(P0.05),差异不明显。三组患儿PCIS分值比较有统计学意义(P0.01),极危重组较危重组极非危重组降低明显;三组间DIC发生率的比较有统计学意义(P0.017),可看出随着病情加重重症肺炎患儿发生DIC的概率增大。5.各凝血指标与PCIS的相关性分析,结果示PLT与PCIS评分相关性分析r=0.365,P0.05,有轻度相关性呈正相关。FIB、FDP及D-D与PCIS评分相关性分析r分别为-0.585、-0.435及-0.46,P0.05,均有中度相关性呈负相关。结论:1.重症肺炎患儿检查的凝血指标PLT、PT、APTT、FIB、FDP及D-D多存在异常改变,且变化方向不完全一致,表明重症肺炎患儿存在不同程度凝血功能障碍。2.重症肺炎患儿PCIS评分越低并发DIC的概率越大,PLT、FIB、FDP及D-D与PCIS存在相关性,表明凝血功能紊乱程度同患儿病情严重程度具有相关性。3.PLT、FIB、FDP及D-D等实验室指标结合PCIS评分分度能更有效判断重症肺炎患儿病情及凝血功能状态,以期早期识别患儿危重程度进行早期干预。
[Abstract]:Objective to summarize the changes and characteristics of coagulation indexes in children with severe pneumonia by detecting the common indexes that can reflect coagulation function in children with severe pneumonia, and to evaluate the coagulation status of children with severe pneumonia. At the same time, the correlation between coagulation indexes and critical case score (PCIS) in evaluating the condition of children with severe pneumonia was analyzed in order to provide theoretical basis for early identification of critical children and timely intervention. Methods the children with pneumonia hospitalized in the affiliated Hospital of Yan'an University from October 2015 to October 2016 were randomly divided into common pneumonia group (n = 30) and severe pneumonia group (n = 30). At the same time, healthy children with general condition matching were selected as control group to detect coagulation series (including PT,APTT,FIB,FDP,D-D) and platelet parameters (including PLT,MPV). The selected children with severe pneumonia were divided into extremely dangerous recombination (鈮，
本文编号：2473464
[Abstract]:Objective to summarize the changes and characteristics of coagulation indexes in children with severe pneumonia by detecting the common indexes that can reflect coagulation function in children with severe pneumonia, and to evaluate the coagulation status of children with severe pneumonia. At the same time, the correlation between coagulation indexes and critical case score (PCIS) in evaluating the condition of children with severe pneumonia was analyzed in order to provide theoretical basis for early identification of critical children and timely intervention. Methods the children with pneumonia hospitalized in the affiliated Hospital of Yan'an University from October 2015 to October 2016 were randomly divided into common pneumonia group (n = 30) and severe pneumonia group (n = 30). At the same time, healthy children with general condition matching were selected as control group to detect coagulation series (including PT,APTT,FIB,FDP,D-D) and platelet parameters (including PLT,MPV). The selected children with severe pneumonia were divided into extremely dangerous recombination (鈮，
本文编号：2473464
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