重症肺炎患儿凝血指标、血小板参数测定的临床意义

摘要

目的 探讨重症肺炎患儿凝血指标、血小板参数测定的意义.方法 选择95例重症肺炎患儿(病例组)和40例健康体检儿童(对照组),将重症肺炎患儿按照血清降钙素原(PCT)的检测结果 分为A组(<2.0ng/mL)和B组(≥2.0ng/mL),对所有研究对象进行抗凝血酶Ⅲ(AT-Ⅲ)、D-二聚体(D-D)、血小板计数(PLT)和平均血小板体积(MPV)检测,将检测结果 进行组间比较,并比较A组和B组弥散性血管内凝血(DIC)发生率.结果 病例组AT-Ⅲ活性低于对照组(P<0.01),D-D、PLT、MPV水平均高于对照组(P<0.01);A组AT-Ⅲ活性、PLT、MPV水平高于B组(P<0.01),D-D水平低于B组(P<0.01),差异均有统计学意义;B组DIC发生率显著高于A组(P>0.05),差异有统计学意义.结论 重症肺炎患儿存在着凝血纤溶功能障碍,进行凝血指标和血小板参数测定可尽早发现凝血功能异常,有助于采取针对性治疗措施,改善预后.%Objective To investigate the clinical significance of coagulation indicator and platelet parameters measurement in children with severe pneumonia. Methods The study selected 95 children with severe pneumonia as the case group and 40 healthy check-up children as the control group. The children with severe pneumonia were di-vided into the group A ( < 2. 0 ng/ml) and the group B ( p 2. 0 ng/ml) according to the serum PCT test results. All the research objects underwent anti-thrombinⅢ( AT-Ⅲ) , D-dimer ( D-D) , platelet count ( PLT) and mean platelet volume ( MPV) test. The test results were compared, and the incidence of disseminated intravascular coagulation ( DIC) in the group A and the group B were compared. Results AT-Ⅲ activity was lower in the case group than in the control group (P<0. 01), and the levels of D-D, PLT and MPV were higher in the case group than in the control group (P<0. 01). The levels of PLT and MPV and the activity of AT-Ⅲ were higher in the group A than in the group B (P<0. 01), and D-D level was lower in the group A than in the group B (P<0. 01). The incidence of DIC was significantly higher in the group B than in the group A (P>0. 05). Conclusion Children with severe pneumo-nia has the coagulation fibrinolytic function obstacle, and coagulant function abnormality can be found as early as pos-sible by coagulation indicator and platelet parameters measurement, which contributes to targeted treatment measures and can improve the prognosis.