降钙素原抗凝血酶Ⅲ和D-二聚体在新生儿重症肺炎诊治中的价值

目的：探讨降钙素原、抗凝血酶Ⅲ和 D-二聚体在新生儿重症肺炎诊治中的价值。方法选取新生儿普通肺炎97例、重症肺炎43例及健康新生儿70例为研究对象。重症肺炎组患儿，按照外周血 PCT 水平分为 PCT ＜2.00 ng／ mL 组和 PCT≥2.00 ng／ mL组。对全部新生儿采集静脉血分别测定血小板（PLT）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（ TT）、纤维蛋白原（FIB）、D 二聚体（DD）和抗凝血酶Ⅲ（AT-Ⅲ）。结果与健康新生儿组比较，普通肺炎组、重症肺炎组 TT 、PT、APTT延长（P ＜0.05），PCT、DD、FIB水平升高（P ＜0.05），AT-Ⅲ和 PLT 水平降低（P ＜0.05）。与普通肺炎组比较，重症肺炎组PCT、AT-Ⅲ和 PLT水平降低（P ＜0.05），DD、FIB 水平升高（P ＜0.05），两组 PT、APTT、TT 比较差异无统计学意义（P ＞0.05）。与PCT ＜2.00 ng／ mL组比较，PCT≥2.00 ng／ mL组的患儿 DIC的发生率高（32.0％ vs 11.1％），ATⅢ活性降低，PLT水平降低，而 DD的水平升高，差异均有统计学意义（P＜0.05）。结论降钙素原、抗凝血酶Ⅲ和D-二聚体在新生儿重症肺炎诊治中具有重要的价值。

The diagnostic value of procalcitionin,antithrombin Ⅲ and D-dimer in neonates with severe pneumonia

Objective To evaluate the diagnosis of procalcitionin,antithrombin Ⅲand D-dimer in neonates with severe pneumonia. Methods The data of 210 neonates hospitalized in our hospital,including 97 neonates with common pneumonia,43 neonates with severe pneumonia,and 70 healthy neonates,during 2012 and 2014 were analyzed retrospectively. The platelets (PLT)count,part of the activation thromoplastin time (APTT),prothrombin time (PT),thrombin time (TT),fibrinogen (FIB),antithrombin Ⅲ (AT-Ⅲ),D-dimer (DD) and procalcitionin (PCT)in the blood were tested within 24 hours after admission. Results PLT and AT-Ⅲ of other groups were significant-ly lower than those of group of healthy neonates(P < 0. 05),while APTT,PT,TT,DD,FIB and PCT significantly rose. However,the difference in PT,APTT,TT and FIB were not significant (P > 0. 05)in common pneumonia and severe pneumonia groups. The incidence of disseminated intravascular coagulation (DIC)in PCT≥2. 00 ng/ mL group was significantly higher than that in PCT < 2. 00 ng/ mL group. Compared with PCT < 2. 00 ng/ mL group,PLT and AT-Ⅲ were significantly lower (P < 0. 05),and DD and FIB were significantly increase (P < 0. 05)in PCT≥2. 00 ng/ mL group. Conclusion The relationship between procalcitionin,antithrombin Ⅲ and D-dimer in neonates with severe pneumonia has intimate connection.