部分儿科疾病D二聚体检测的临床意义

THE MEASUREMENT OF D - DIMER IN PEDIATRIC DISEASES

目的:检测10种儿科疾病患儿血浆D二聚体并探讨其临床意义。方法:应用Latex法对181例患10种不同疾病的患儿及50例,健康儿童进行D二聚体测定。结果:正常对照组50例D二聚体阳性1例(2％)。患病组181例,阳性86例(47.51％);其中川崎病急性期15例,阳性13例(86.67％);原发性血小板减少性紫癜9例,阳性0例(0％);其余疾病阳性率分别是:新生儿缺氧缺血性脑病(85.71％),败血症(71.43％),肾病(66.67％),婴儿肝炎综合征(58.33％),过敏性紫癜(50％),重症肺炎(37.2％),蚕豆病(33.33％),新生儿硬肿症(30％)。结论:儿科多种疾病存在血液高凝状态,在可能存在血液高凝状态和微血栓形成的疾病中D二聚体检测有较高的阳性率;Latex法检测患儿D二聚体,对小儿各种疾病病程中血液高凝状态的诊断及指导抗凝剂的使用有较高的参考价值。

Objective:To detect and evaluate the plasma D- dimer in ten kinds of pediatric diseases. Methods: The Latex method were performed in 181 cases with respective ten kinds of pediatric illness and 50 normal cases for measurement of D-dimer. Results:One case in the normal group was D- dimer postive(2% ). At the same time,86 cases were found D - dimer postive in 181 cases, including 13 cases positive out of 15 patients with Kawasski disease (KD)(86. 67%) ;zero cases positive out of 9 cases with primary thrombocytopenic purpura(0%) ;the positive rates of other cases were hypoxia - ischemia brain disease (85. 71 % ) ; sapraemia( 71.43 % ) ; nephrosis ( 66. 67 % ) ; neonatal hepatitis syndrome (58.33%);allergic purpura (50%);severe pneumonia(37.2%) ;flavism(33. 33% ).Conclusion:The D -dimer measurement is often positive in blood hypercoagulable condition and microthrombosis disease that often exist in pediatric cases and it can play important role in diagnosis and treatment of pediatric diseases.