论文部分内容阅读
目的 探讨重症肺炎合并高凝状态的实验室诊断标准及评价肝素抗凝治疗有效的实验室指标。方法 测定2 0 0 1年1 0月至2 0 0 3年6月佛山市顺德妇幼保健院和顺德杏坛医院收治的52例重症肺炎患儿治疗前后的D -二聚体(D -Dimer)、抗凝血酶Ⅲ(AT Ⅲ)、凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血时间(APTT)、纤维蛋白原(Fbg)及氧饱和度(SaO2 ) ,并进行对比。结果 52例重症肺炎患儿中2 0例的D- Dimer升高,治疗前3 2例患儿的AT Ⅲ活性及SaO2 明显降低,TT、APTT明显缩短。经肝素治疗后,2 0例治疗组患儿的D- Dimer下降、SaO2 升高、TT延长、Fbg下降。结论 重症肺炎存在高凝状态,其实验室诊断参考指标是:D- Dimer升高、AT Ⅲ降低、TT、APTT缩短。评价肝素抗凝治疗有效的实验室指标是:D -Dimer下降,AT Ⅲ活性>70 % ,TT、PT、APTT延长,Fbg下降。
Objective To investigate the laboratory diagnostic criteria of severe pneumonia complicated with hypercoagulable state and to evaluate the effective laboratory parameters of heparin anticoagulation therapy. Methods Twenty-two children with severe pneumonia admitted to Foshan Shunde Maternal and Child Health Hospital and Shunde Xingtan Hospital from January 2001 to June 2003 were tested for D-dimer (D-dimer) , Antithrombin Ⅲ (AT Ⅲ), thrombin time (TT), prothrombin time (PT), activated partial clotting time (APTT), fibrinogen (Fbg) and oxygen saturation (SaO2) Compared. Results Twenty-two children with severe pneumonia were found to have increased D-Dimer. The AT Ⅲ activity, SaO_2 and TT, APTT were significantly reduced in 32 children before treatment. After treatment with heparin, D-Dimer decreased, SaO2 increased, TT prolonged, and Fbg decreased in 20 treated children. Conclusions There is hypercoagulable state in severe pneumonia. The laboratory diagnostic criteria are as follows: increased D-dimer, decreased AT III and shortened TT and APTT. Evaluation of heparin anticoagulant effective laboratory indicators are: D-Dimer decreased, AT Ⅲ activity> 70%, TT, PT, APTT prolonged, Fbg decreased.