感染患儿凝血相关指标的变化及其临床意义  

Changes and clinical value of blood coagulation indexes in children with infection

作　　者：王成云 顾萍[1] 潘秋辉[1] 王静 WANG Chengyun;GU Ping;PAN Qiuhui;WANG Jing(Department of Blood Transfusion,Shanghai Children's Medical Center,Shanghai Jiaotong University School of Medicine,National Children's Medical Center,Shanghai 200127,China)

机构地区：[1]国家儿童医学中心,上海交通大学医学院附属上海儿童医学中心输血科,上海200127

出　　处：《检验医学》2025年第2期178-181,共4页Laboratory Medicine

摘　　要：目的分析感染患儿凝血相关指标的变化及其临床意义。方法收集2021年1月—2022年12月上海交通大学医学院附属上海儿童医学中心不同原发疾病感染患儿(感染组)和对应原发疾病未感染患儿凝血功能检测标本各3932例,另收集同期体检正常儿童(正常对照组)凝血功能检测标本3932例。比较感染组和正常对照组相关指标差异。结果与正常对照组比较,感染组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)延长,纤维蛋白(原)降解产物(FDP)、D-二聚体(DD)升高,抗凝血酶Ⅲ(AT-Ⅲ)活性降低(P<0.05);纤维蛋白原(Fib)差异无统计学意义(P>0.05)。心血管疾病、泌尿系统疾病、呼吸系统疾病、腹腔疾病和血液系统疾病感染患儿PT、APTT、TT、Fib、FDP和DD水平不同。血液系统疾病患儿感染后AT-Ⅲ活性下降(P<0.05);重症肺炎患儿AT-Ⅲ活性低于非重症肺炎患儿。结论凝血指标对于患儿临床感染的诊断有一定价值,可根据相关凝血指标监测不同疾病患儿感染状态。Objective To analyze the changes and clinical value of blood coagulation indexes in infected children with different primary diseases.Methods From January 2021 to December 2022,3932 infected children(infected group)and 3932 uninfected children with corresponding primary diseases(uninfected group)were enrolled from Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine,and 3932 healthy children(healthy control group)were enrolled for coagulation function determination.The difference of relevant indexes between infected group and healthy control group was compared.Results Compared with healthy control group,prothrombin time(PT),activated partial thromboplastin time(APTT)and thrombin time(TT)were prolonged,fibrin/fibrinogen degradation product(FDP)and D-dimer(DD)were increased,and antithrombin-Ⅲ(AT-Ⅲ)activity was decreased in infected group(P<0.05).There was no statistical significance in fibrinogen(Fib)(P>0.05).The levels of PT,APTT,TT,Fib,FDP and DD were different in children infected with diseases of cardiovascular system,urinary system,abdominal system and blood system.AT-Ⅲactivity was decreased after infection in children with hematological diseases(P<0.05).AT-Ⅲactivity in children with severe pneumonia was lower than that in children without severe pneumonia(P<0.05).Conclusions Blood coagulation indexes have certain value for the diagnosis of infection in children,and the infection status of children with different diseases can be monitored according to the relevant blood coagulation indexes.

关 键 词：凝血功能 凝血指标 感染 儿童 诊断 

分 类 号：R446.11[医药卫生—诊断学]