婴幼儿重症肺炎肝素超声雾化治疗中血浆D-D的检测及意义

目的：探讨肝素超声雾化对婴幼儿重症肺炎血浆D-二聚体（D-D）的影响及临床意义。方法：将78例婴幼儿重症肺炎随机分成2组,治疗组46例,对照组32例,对照组为常规治疗（包括吸氧、抗感染、强心及对症治疗）,治疗组为对照组基础上加肝素（钠）300u/kg/次,超声雾化吸入,2次/d,疗程5d。采用免疫渗滤法分别测定治疗前后患儿血浆的D-D含量,并进行比较。结果：治疗组与对照组治疗前、后及治疗后治疗组与对照组的D-D水平比较,差异均有显著性意义（P〈0.01）。结论：血浆D-D检测可做为婴幼儿重症肺炎肝素超声雾化治疗时对病情的监测指标之一。

Significance of Changes of Plasma D-Dimer Contents in Infants and Children with Severe Pneumonia Treated with Ultrasonic-Nebulized Heparin

Objective To study the therapeutic efficacy of ultrasonic-nebulized heparin in infants and children with severe pneumonia.Methods Plasma D-dimer contents were determined with immuno-percolation technique in 46 infants and children with severe pneumonia treated with a course of ultrasonic-nebulized heparin（300u/kg bid ×5d） and 32 patients treated with conventional therapy only both before and after the treatment course.Results Plasma D-dimer contents in the two groups of patients before treatment were about the same.The D-dimer contents in both groups dropped significantly after treatment（P0.01）.However,the final plasma D-dimer contents were significantly lower in the heparin treated patients than those in patients without ultrasonic nebulized heparin treatment（P0.01）.Conclusion Nebulized heparin therapy was very effective for treatment of disorders of blood coagulation developed during severe infection and monitoring of changes of plasma D-dimer contents would be useful clinically for assessment of disease status in infants and children with severe pneumonia.