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目的研究婴幼儿肺炎并发不同程度心力衰竭时内皮素(ET)、D-二聚体(D-dimer)、纤维蛋白原(FBG)等变化及其内在联系,探讨该阶段血管内皮功能、凝血、纤溶功能的变化。方法选择2005-12—2006-8于邯郸市中心医院儿科就诊的肺炎及肺炎并发不同程度心力衰竭患儿80例作为观察组,健康婴幼儿20例作为对照组,均抽血检测ET、D-dimer、FBG、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)值。结果各组间ET、D-dimer、FBG、APTT存在统计学差异,心衰程度越重,ET、D-dimer、FBG越高,APTT越低,其中以肺炎并发重度心衰组明显,ET与D-dimer间呈正相关(r=0.42,P<0.01);D-dimer与FBG间也呈正相关(r=0.30,P<0.01)。结论婴幼儿肺炎并发心力衰竭时存在内皮细胞功能紊乱和凝血、纤溶系统的激活。
Objective To study the changes of endothelin (ET), D-dimer and fibrinogen (FBG) in infants with pneumonia complicated with different degrees of heart failure, and to explore the intrinsic relationship between the changes of endothelial function, coagulation, Changes in fibrinolytic function. Methods Select 2005-12-2006-8 in Handan Central Hospital pediatric pneumonia and pneumonia complicated with varying degrees of heart failure in 80 children as observation group, 20 healthy infants and young children as a control group, blood tests were detected ET, D- dimer, FBG, activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) values. Results The ET, D-dimer, FBG and APTT among the groups were statistically different. The more heart failure, the higher ET, D-dimer and FBG, the lower the APTT. Among them, severe pneumonia complicated with severe heart failure, ET and D-dimer (r = 0.42, P <0.01). There was also a positive correlation between D-dimer and FBG (r = 0.30, P <0.01). Conclusions There are endothelial dysfunction and coagulation and fibrinolysis activation in infantile pneumonia complicated by heart failure.