大叶性肺炎患儿凝血和免疫相关指标的分析及临床意义

目的了解大叶性肺炎患儿凝血和免疫相关指标水平变化情况,探讨其对临床诊疗的意义。方法收集2016年1月至2018年12月常熟市第二人民医院确诊的102例大叶性肺炎患儿一般资料,相关凝血及免疫指标水平,根据病情严重程度分为重度组(21例)和轻度组(81例),比较各组的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fib)、血小板计数(PLT)、D-二聚体(DD)等凝血指标和免疫球蛋白(Ig)M、IgG、IgA、CD3^+、CD4^+、CD8^+和CD4^+/CD8^+相关免疫指标。结果发病年龄主要集中在6岁以下,重度组患儿PT、APTT、TT、DD水平均明显高于轻度组患儿,APTT、DD异常比例明显高于轻度组患儿。重度组患儿IgG、IgM、IgA水平均高于轻度组患儿,差异均有统计学意义(P<0.05),CD4^+水平、CD4^+/CD8^+显著低于轻度患儿,差异均有统计学意义(P均<0.05)。结论大叶性肺炎患儿的凝血和免疫功能均存在一定程度异常,对临床诊治该病有重要的指导意义。

Clinincal reasearch of coagulation function and immunologic function indexes in lobar pneumonia in children

Objective To analyze the changes of coagulation function and immunologic function indexes in children with lobar pneumonia,and to explore its significance in clinical diagnosis and treatment.Methods One hundred and two lobar pneumonia in children′indexes in Changshu the Second People′s Hospital from January 2016 to December 2018 were selected,including coagulation indexesProthrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),platelet(PLT)]and immunologic indexesimmunoglobulin(Ig)M,IgG,IgA].According to the severity degree,patients were divided into high risk group(n=21)and low risk group(n=81),the coagulation function indexes of PT,APTT,TT,DD and immunologic function indexes of IgM,IgG,IgA,CD3^+,CD4^+,CD8^+and CD4^+/CD8^+were compared among these groups.Results The age of onset was mainly under 6 years.The PT,APTT,TT and DD in high risk group were significantly higher than those in low risk group(P<0.05).The abnormal rate of APTT and DD in high risk group were significantly higher than low risk group(P<0.05).The levels of IgG,IgM,IgA in high risk group were significantly higher than those in low risk group,and CD4^+,CD4^+/CD8^+were significantly lower than those in low risk group(P<0.05).Conclusion There is a certain degree of abnormality in coagulation and immunologic function of children with lobar pneumonia,which has directive importance to the diagnosis and treatment of this disease.