本文關(guān)鍵詞： 重癥肺炎 纖維蛋白單體 D-二聚體 兒童　出處：《臨床兒科雜志》2016年08期 　論文類型：期刊論文

【摘要】：目的探討纖維蛋白單體(FM)、D-二聚體(D-D)、纖維蛋白(原)降解產(chǎn)物(FDP)3種纖維蛋白相關(guān)標(biāo)志物在重癥肺炎患兒彌散性血管內(nèi)凝血前狀態(tài)(Pre-DIC)中的診斷價值。方法 213例重癥肺炎患兒根據(jù)其是否合并Pre-DIC分為Pre-DIC組和病例對照組,另選擇40例健康兒童作為正常對照組。分析各組的FM、D-D、FDP、凝血酶原時間(PT)、活化部分凝血活酶時間(APTT)、纖維蛋白原(FIB)、血小板計數(shù)(PLT)、血栓調(diào)節(jié)蛋白(TM)水平,應(yīng)用受試者工作特征曲線對各指標(biāo)進行比較和評價。結(jié)果三組間除FIB外其余各指標(biāo)差異均有統(tǒng)計學(xué)意義(P均0.05),其中FM、D-D、FDP、APTT三組間兩兩比較差異均有統(tǒng)計學(xué)意義(P均0.01),Pre-DIC組最高,病例對照組次之;Pre DIC組的PT明顯高于正常對照組與病例對照組(P0.05),而后兩組的PT差異無統(tǒng)計學(xué)意義(P0.05);Pre-DIC組和病例對照組的TM和PLT均高于正常對照組(P0.01),但前兩組的差異均無統(tǒng)計學(xué)意義(P0.05)。各指標(biāo)中FM、D-D、FDP診斷重癥肺炎患兒DIC前狀態(tài)的曲線下面積較大,分別為0.84、0.76、0.64,三者聯(lián)合診斷時曲線下面積為0.85。結(jié)論纖維蛋白相關(guān)標(biāo)志物FM、D-D、FDP可作為重癥肺炎患兒Pre-DIC診斷中有價值的標(biāo)志物,3項聯(lián)合檢測可提高診斷準(zhǔn)確性。
[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 鹵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.
【作者單位】： 湖南省兒童醫(yī)院檢驗科;
【基金】：湖南省衛(wèi)生和計劃生育委員會應(yīng)用研究項目(No.B2015-127)
【分類號】：R725.6;R446.1
【正文快照】： 兒童重癥肺炎容易誘發(fā)凝血功能障礙和彌散性血管內(nèi)凝血(disseminated intravascular coagulation,DIC)[1-3],而DIC是導(dǎo)致重癥肺炎患兒死亡的重要原因,由于其臨床表現(xiàn)無特異性,容易被忽視而加重病情。 因此重癥肺炎患兒DIC早期狀態(tài)即DIC前狀態(tài)(PreDIC)的發(fā)現(xiàn)和診斷并及時采取

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