小儿全身炎症反应综合征t-PA、PAI-1的变化及临床意义

The alteration of plasma t-PA?PAI-1 in children with SIRS and their clinical significance

目的:观察全身炎症反应综合征(SIRS)患儿综合治疗前后血浆组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制物-1(PAI-1)的变化及临床意义。方法:住院SIRS患儿35例,按是否合并多器官功能障碍综合征(MODS)分为单纯SIRS组(17例)和合并MODS组(18例)。入院24h内(初期)、综合治疗3天后(恢复期)各收集血液标本1次,测定血浆t-PA(发色底物法)、PAI-1(发色底物法)等指标。正常对照组20例。结果:各组患儿在发病初期,血浆PAI-1水平较正常对照组显著升高,血浆t-PA水平下降,合并MODS组与单纯SIRS组分别与正常对照组及两组间比较差异均有显著性(P<0.01)。恢复期各观察指标均明显好转(P<0.01)。结论:SIRS患儿存在血管内皮系统的损伤及凝血纤溶系统的紊乱,且这些分子标志物的变化以合并MODS组尤为明显。

Objective：The present study was undertaken to observe the alteration of plasma t-PA,PAI-1 and the coagulation disorder in the patients with SIRS. Medthods ： 35 SIRS patients were divided into the group of SIRS group without MODS and SIRS group with MODS,and the control group consisted of 20 health children. The plasma levels of t-PA,PAI-1 were measured by developing substrate method. Results：In the prime of SIRS,the plasma levels of t-PA were lower and PAI-1 were significanlly higher than that of the control group（P〈0.01 ）. After SIRS was controlled ,the levels of t-PA were increased and PAI-1 were decreased（P〈0.01 ）. Conclusion ：These findings indicate that there are vascular endothelial damage and abnormality in coagulation and fibrinolysis in the patients with SIRS. The levels of molecular markers were changed significantly in SIRS group with MODS.