败血症患儿血小板计数、D-二聚体水平与危重病例评分及预后相关性研究  

Correlation between Pediatric Critical Illness Score and Prognosis with Platelet Count and D-Dimer Level in Children with Septicemia

作　　者：马存军 张诗海 MA Cunjun;ZHANG Shihai(Department of Clinical Laboratory,Anhui Provincial Children's Hospital,Heifei 230051,China)

机构地区：[1]安徽省儿童医院临床检验科,合肥230051

出　　处：《医学综述》2020年第5期1013-1016,共4页Medical Recapitulate

摘　　要：目的分析败血症患儿血小板计数、D-二聚体水平与小儿危重病例评分(PCIS)及预后的相关性。方法收集2016年1月至2019年8月安徽省儿童医院儿科重症监护病房收治的91例败血症患儿资料进行回顾性研究。根据患儿的PCIS分值将其分为非危重组(n=48)、危重组(n=27)和极危重组(n=16),比较三组患儿的血小板水平、D-二聚体水平以及死亡的例数。根据患儿预后将患儿分为存活组(n=82)和死亡组(n=9),比较两组患儿的PCIS评分、血小板计数、D-二聚体水平。分析血小板计数以及D-二聚体水平与预后的相关性。结果极危重组患儿D-二聚体水平高于非危重组和危重组[(10.86±2.75)mg/L比(1.53±0.33)mg/L比(3.42±0.74)mg/L](P<0.05),而危重组高于非危重组(P<0.05)。三组患儿血小板计数比较差异无统计学意义(P>0.05)。极危重组中有9例死亡,非危重组和危重组无死亡病例。死亡组患儿的D-二聚体水平高于存活组[(11.01±3.25)mg/L比(2.82±0.54)mg/L](P<0.01),PCIS评分低于存活组[(67.89±0.63)分比(83.06±1.07)分](P<0.01)。相关性分析显示,死亡组患儿D-二聚体水平与PCIS评分呈正相关(r=0.518,P<0.001),血小板计数与PCIS评分无相关性(r=-0.120,P=0.258)。结论败血症患儿血清D-二聚体的水平随着病情严重程度增加而升高,并与败血症患儿的预后相关,有望成为判断败血症患儿病情以及预测预后的指标。Objective To analyze the correlation of platelet count,D-dimer level with prognosis and pediatric critical illness score(PCIS)of children with septicemia.Methods A retrospective study was conducted on 91 children with septicemia admitted to the pediatric intensive care unit of Anhui Provincial Children’s Hospital from Jan.2016 to Aug.2019.The children were divided into a non-critical group(n=48),a critical group(n=27)and an extremely critical group(n=16)according to their PCIS score,and the platelet level,D-dimer level and the number of deaths in the three groups were compared.According to the prognosis,the children were divided into a survival group(n=82)and a death group(n=9),and the PCIS,platelet count and D-dimer level of the children in the two groups were compared.Correlation analysis was used to investigate the correlation between platelet count and D-dimer levels and the prognosis of death.Results The level of D-dimer in the extremely critical group was higher than that in the non-critical group and the critical group[(10.86±2.75)mg/L vs(1.53±0.33)mg/L,(3.42±0.74)mg/L](P<0.05),while the critical group was higher than the noncritical group(P<0.05).There was no significant difference in platelet count among the three groups(P>0.05).There were 9 deaths in the extremely critical group,and no death in the non-critical and critical groups.D-dimer level in the death group was higher than that in the survival group[(11.01±3.25)mg/L vs(2.82±0.54)mg/L],PCIS in the death group was lower than that in the survival group(67.89±0.63 vs 83.06±1.07)(P<0.01).There was a positive correlation between D-dimer level and PCIS(r=0.518,P<0.001),but no correlation between platelet count and PCIS(r=-0.120,P=0.258).Conclusion The level of serum D-dimer in the children is increased with the severity of the disease and it is related to the prognosis of the children with septicemia,which is expected to be an indicator to judge the condition and predict the prognosis of septicemia.

关 键 词：小儿败血症 小儿危重病例评分 儿科重症监护病房 血小板 D-二聚体 预后 

分 类 号：R447[医药卫生—诊断学]