凝血纤溶指标在小儿感染性腹泻病情评价中的应用价值  

Values of coagulation and fibrinolysis indexes in evaluation of illness condition of children with infectious diarrhea

作　　者：胡玲[1] 唐锋 王宝香[3] HU Ling;TANG Feng;WANG Bao-xiang(Wuhan Children's Hospital,Tongji Medical College Huazhong University of Science and Technology,Wuhan,Hubei 430016,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院神经内科,湖北武汉430016 [2]华中科技大学同济医学院附属武汉儿童医院检验科,湖北武汉430016 [3]华中科技大学同济医学院附属武汉儿童医院消化内科,湖北武汉430016

出　　处：《中华医院感染学杂志》2024年第13期2054-2058,共5页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金委(医学部)面上基金资助项目(82072351);武汉市卫生健康青年人才第一届研修班基金资助项目(2021);武汉市医学科学研究基金资助项目(WX23A65)。

摘　　要：目的对比分析凝血纤溶指标在小儿感染性腹泻病情评价中的应用价值。方法去选取2021年4月一2023年4月在华中科技大学同济医学院附属武汉儿童医院就诊的122例感染性腹泻患儿为研究组,依据其病情严重程度分为轻度组35例、中度组51例和重度组36例,选取同期100名接受体检的儿童作为对照组。对各组儿童的外周血凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)及纤维蛋白原(FIB)、组织纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制物-1(PAI-1)、纤维蛋白降解产物(FDP)、D-D二聚体(D-D)水平进行检测和比较。采用受试者工作特征(ROC)曲线分析上述指标诊断重度小儿感染性腹泻的价值。结果对照组、轻度组、中度组、重度组儿童的FIB、t-PA、PAI-1、FDP、D-D水平依次升高(P<0.05);上述指标水平与研究组患儿的病情严重程度呈正相关关系(P<0.05)。FIB、t-PA、PAI-1、FDP、D-D诊断重度感染性腹泻的ROC曲线下面积(AUC)均有统计学意义(P<0.05),其中,FDP的AUC及在Cutoff值下的灵敏度最高,其次为D-D和t-PA。结论感染性腹泻患儿表现为部分凝血纤溶指标的异常,这些指标水平与患儿的病情严重程度具有相关性,FDP、D-D、t-PA等指标有望作为新型标志物用于小儿感染性腹泻的病情评价。OBJECTIVE To compare and analyze the values of coagulation and fibrinolysis indexes in evaluation of illness condition of the children with infectious diarrhea.METHODS A total of 122 children with infectious diarrhea who were treated in Wuhan Children's Hospital,Tongji Medical College Huazhong University of Science and Tech-nology from Apr 2021 to Apr 2023 were assigned as the study group and were divided into the mild group with 35 cases,the moderate group with 51 cases and the severe group with 36 cases according to the severity of illness condition,meanwhile,1oo children who received physical examination were chosen as the control group.The pe-ripheral blood prothrombin time(PT),activated partial thromboplastin time(APTT)and thrombin time(TT)as well as the levels of fibrinogen(FIB),tissue plasminogen activator(t-PA),plasminogen activator inhibitor type 1(PAI-1),fibrin degradation product(FDP)and D-dimer(D-D)were detected and compared among the groups.The values of the above indexes in diagnosis of severe infectious diarrhea were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The levels of FIB,t-PA,PAI-1,FDP and D-D were successively elevated in the control group,the mild group,the moderate group and the severe group(P<0.05).The levels of above indexes were positively correlated with the severity of illness condition of the study group(P<0.05).There was significant difference in the area under ROC curve(AUC)for diagnosis of the severe infectious diarrhea among FIB,t-PA,PA1-1,FDP and D-D(P<0.05),the AUC of FDP shows the highest sensitivity under the cutoff value,followed by D-D and t-PA.CONCLUSION The children with infectious diarrhea show abnormal coagulation and fibrinolysis indexes,which are associated with the severity of illness condition of the children.The FDP,D-D and t-PA are expected to be novel markers for evaluation of illness condition of the children with infectious diarrhea.

关 键 词：凝血指标 纤溶指标 小儿 感染性腹泻 病情评价 

分 类 号：R725.7[医药卫生—儿科]