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目的探讨早产儿假丝酵母菌败血症时血小板的变化。方法回顾性分析2008年2月至2010年2月在本院住院的假丝酵母菌败血症早产儿的临床表现,比较患儿入院时、发生真菌败血症时、抗真菌治疗2周后3个时间点的血常规特别是血小板的变化和C反应蛋白(CRP)变化。结果白假丝酵母菌败血症13例,近平滑假丝酵母菌败血症11例。24例患儿发生假丝酵母菌败血症时与入院时比较,WBC(×109/L)差异无统计学意义[(8.5±4.3)比(8.6±2.9),P>0.05]。PLT(×109/L)降低,CRP(mg/L)、血小板平均体积(MPV,fl)和血小板分布宽度(PDW,%)升高[PLT:(99.8±49.1)比(197.0±62.8),CRP:(29.3±34.5)比(2.7±3.4),MPV:(12.3±0.9)比(11.1±1.1),PDW:(17.6±3.2)比(13.6±2.7),P均<0.05]。近平滑假丝酵母菌组发生败血症时PLT明显低于白假丝酵母菌组[(73.0±40.9)比(122.5±44.8),P<0.05],其余血常规指标在3个不同时间点两组相比差异均无统计学意义(P>0.05)。结论早产儿真菌败血症时血常规变化最明显的指标是PLT降低,与白假丝酵母菌败血症相比,近平滑假丝酵母菌败血症PLT降低更明显,分析PLT可辅助指导真菌败血症的诊断和早期经验治疗。
Objective To investigate the changes of platelets in Candida septicemia of prematurity. Methods The clinical manifestations of Candida septicemia premature infants hospitalized in our hospital from February 2008 to February 2010 were retrospectively analyzed. Fungal septicemia was observed in hospitalized children at 3 time points after 2 weeks of antifungal therapy Of blood, especially platelet changes and C-reactive protein (CRP) changes. Results Candida albicans septicemia in 13 cases, nearly smooth Candida septicemia in 11 cases. 24 cases of children with Candida septicemia compared with admission, WBC (× 109 / L) no significant difference [(8.5 ± 4.3) vs (8.6 ± 2.9), P> 0.05]. (PLT: (99.8 ± 49.1) vs (197.0 ± 62.8), PLT (109 / L), CRP (mg / L), platelet mean volume (MPV, fl) and platelet distribution width CRP: (29.3 ± 34.5) vs (2.7 ± 3.4), MPV: (12.3 ± 0.9) vs (11.1 ± 1.1), PDW: (17.6 ± 3.2) vs (13.6 ± 2.7), P all <0.05. PLT of Candida parahaemolyticus group was significantly lower than that of Candida albicans group [(73.0 ± 40.9) vs (122.5 ± 44.8), P <0.05], and the remaining blood routine indexes were at two different time points Compared with the difference was not statistically significant (P> 0.05). Conclusion The most obvious index of blood routine changes in fungal sepsis in preterm infants is PLT reduction. Compared with C. albicans septicemia, the PLT reduction of Candida parapsilosis septicemia is more obvious. Analysis of PLT can help guide the diagnosis and early stage of fungal septicemia Experience treatment.