小儿全身炎症反应综合征血浆AT-Ⅲ、D-二聚体的变化  

The measurement of AT-Ⅲ activity and D-dimer quantity in plasma from patients with SIRS

作　　者：胡月[1] 刘春峰[1] 袁壮[1] 徐大庆[1] 代锡阳 

机构地区：[1]中国医科大学第二临床学院 [2]沈阳苏家屯区妇婴医院儿科,辽宁沈阳110101

出　　处：《小儿急救医学》2001年第4期208-210,共3页Pediatric Emergency Medicine

摘　　要：目的　 观察小儿全身炎症反应综合征 (SIRS)凝血系统功能紊乱情况 ,探讨凝血系统紊乱在SIRS/MODS中的作用及其与SIRS/MODS严重程度的关系 ,为临床防治提供理论依据。 方法 　采用发色底物法及酶联免疫吸附法 (ELISA法 )对 43例SIRS患儿及 19例非SIRS患儿血浆AT Ⅲ活性、D dimer含量进行检测 ,同时做DIC筛查。 结果 　SIRS组与对照组和非SIRS组比较 ,AT Ⅲ活性明显减低 ,D dimer含量明显升高 ;SIRS合并MODS与SIRS未合并MODS者比较 ,AT Ⅲ活性明显减低 ,D dimer含量明显升高 ;死亡组与存活组比较 ,AT Ⅲ活性明显减低 ,D dimer含量明显升高 ;SIRS未合并DIC时MODS的发生率为32 0 % ,合并DIC时MODS的发生率为 83 3 % (P <0 0 1)。 结论 　SIRS患儿存在凝血纤溶功能异常 ,DIC为其主要表现之一 。Objective To investigate the coagulation disorder in the patients with SIRS and the relation to severity of SIRS/MODS,combining with the clinical screening of DIC,and provide evidences for the prevention and treatment of DIC.Methods The activity of AT Ⅲ was measured by chromogenic substrate method.The quantity of D dimer was measured by enzyme linked immunosorbent assay.Results The acitivity of AT Ⅲ was lower and the quantity of D dimer was significantly higher in SIRS group than that.Activity of AT Ⅲ in SIRS group with MODS was lower than SIRS group without MODS.The quantity of D dimer of SIRS group with MODS was significantly higher than that of SIRS group without MODS.The incidence of MODS in non DIC Patients was 32 0%,and it was 83 3% in patients with DIC(P<0 01).Conclusion Patients with SIRS have abnormality in coagulation and fibrinolysis.It is suggested that DIC is the most important factor in disorder of coagulation and fibrinolytic system.It plays an important role in development form SIRS to MODS in severe patients.

关 键 词：全身炎症反应综合征 多器官功能障碍综合征 弥散性血管内凝血 AT-Ⅲ DIC D-二聚体 

分 类 号：R720.597[医药卫生—急诊医学]