肺炎并心力衰竭患儿内皮素、D-二聚体、纤维蛋白原变化的意义

目的研究婴幼儿肺炎并不同程度心力衰竭(心衰,HF)时内皮素(ET)、D-二聚体(D-dimer)、纤维蛋白原(Fbg)等变化及其联系,探讨该阶段血管内皮功能、凝血、纤溶功能变化。方法选择肺炎及肺炎并HF患儿80例作为观察组,健康婴幼儿20例作为对照组。均抽血检测ET、D-dimer、Fbg、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)。结果各组ET、D-dimer、Fbg、APTT有差异。心衰程度越重,ET、D-dimer、Fbg越高,APTT越低。其中以肺炎并重度心衰组明显,ET与D-dimer呈正相关(r=0.42P<0.01);D-dimer与Fbg亦呈正相关(r=0.30P<0.01)。结论肺炎并HF婴幼儿存在内皮细胞功能紊乱和凝血、纤溶系统激活;ET、D-dimer、Fbg增高可反映心衰严重程度。

Significance of Changes of Serum Endotheline, D - Dimer and Fibrinogen in Infants with Pneumonia Complicated with Heart Failure

Objective To study the changes of serum endotheline(ET),D-dimer and fibrinogen(Fbg) in infants with pneumonia complicated with heart failure(HF) and explore the changes of blood coagulation,fibrinolysis,and endothelial cell function.Methods Eighty patients with infant pneumonia complicated with HF and 20 controls were studied.Serum ET,D-dimer,Fbg,activated partial thromboplastin time(APTT),prothrombin time(PT) and thrombin time(TT) were measured.Results ET,D-dimer,Fbg,APTT in every group had differences.With the disease deteriorating,the values of ET,D-dimer,Fbg increased,but the values of APTT decresed gradually.There were positive relations between ET and D-dimer(r=0.42 P<0.01),D-dimer and Fbg(r=0.30 P<0.01).Conclusions Pneumonia complicated with HF has important impacts on coagulation,fibrinolysis and endothelial cell function.The increase of ET,D-dimer and Fbg can reflect the degree of HF.