肺炎心力衰竭患儿内皮素D-二聚体及纤维蛋白原变化的临床研究

Changes of serum endotheline,D-dimer and fibrinogen in infants with pneumonia complicated with heart failure

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 serum endotheline （ ET ）, D-dimer and fibrinogen （ FBG ） in infants with pneumonia complicated with heart failure （ HF） and explore the changes of blood coagulation, fibrinolysis,and endothelial cell function. Methods Eighty patients with infant pneumonia complicating HF and 20 controls were studied. Serum ET＇ D-dimer, FBG, activated partial thromboplastin time （ APTT ）, prothrombin time （ PT ） and thrombin time （ TT ） were measured. Results ET, D-dimer, FBG, APTT in two groups had difference. With the disease deteriorating, the values of ET, Ddimer, FBG increased, and APTT decreased gradually. There are positive relations between ET and D-dimer, D-dimer and FBG. Conclusion Pneumonia complicated with HF has important impacts on coagulation,fibrinolysis and endothelial cell function.