全身炎症反应综合征患儿凝血功能变化的临床意义

目的探讨全身炎症反应综合征(SIRS)的危重病患儿凝血功能的变化及临床意义。方法随机选择合并SIRS的危重病患儿50例,及同期住院的非SIRS患儿60例,分别检测各组患儿的血浆D-二聚体(DD)、凝血酶原时间(PT)、凝血酶时间(TT)、部分凝血活酶时间(APTT)及血小板(PLT)计数。结果SIRS组与非SIRS组相比:D-二聚体含量明显升高(P<0.05);PT、TT、APTT均延长(P<0.05);PLT计数降低(P<0.05)。SIRS组中多器官功能障碍综合征(MODS)及单器官功能不全组患儿与非SIRS组相比DD含量升高更明显,PLT计数降低更明显,PT、TT、APTT延长更明显,差异有显著性意义(P<0.01)。结论SIRS患儿存在凝血纤溶系统的功能紊乱,检测D-二聚体、PT、TT、APTT、PLT等指标,可了解SIRS患儿体内凝血纤溶系统的变化,是早期发现弥漫性血管内凝血(DIC)的敏感指标。

Changes and clinical significance of coagulation functions in children with systemic inflammatory response syndrome

Objective To explore changes and clinical significance of coagulation functions in children with systemic inflammatory response syndrome(SIRS).Methods Fifty SIRS severe children and 60 concurrent non-SIRS children were randomly selected.Levels of D-dimer,platelet(PLT),prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT) were measured in two groups respectively.Results Levels of D-dimer,TT,APTT,PT were significantly higher in SIRS children compared to those of the non-SIRS children(P<0.05).PLT decreased significantly in SIRS group compared to the non-SIRS group(P< 0.05).The changes of the levels of D-dimer,APTT,TT and PLT in SIRS children with multiple organ dysfunction syndrome(MODS) or single organ dysfunction were significantly higher compared to those of non-SIRS children(P<0.01),there was a significant difference.Conclusion There are dysfunctions of coagulation in children with SIRS.Detection of D-dimer,PT,TT,APTT and PLT can clarify changes of coagulation and fibrinolytic system in SIRS children and is sensitive markers for detecting DIC in early stage.