新生儿全身炎症反应综合征凝血功能的研究

Study on coagulation function in newborns with system inflammatory response syndrome

目的探讨新生儿全身炎症反应综合征(SIRS)凝血功能的变化及其临床意义。方法将符合SIRS诊断标准的80例新生儿患者,以SIRS符合项数分组,分为SIRS2(符合2项)、SIRS3(符合3项)、SIRS4(符合4项);对照组为同期病房中非SIRS新生儿,共50例。所有患儿在入院后24h内进行危重病例评分,根据评分结果分为危重症组(≤90分)和非危重症组(>90分),其中危重症组63例,非危重症组67例。入院后24h内采血测定凝血酶原时间(PT)、凝血酶时间(TT)、部分活化凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(DD)和血小板(PLT)。结果 SIRS组与对照组比较,D-二聚体含量明显升高(P<0.05),PT、TT、APTT均延长(P<0.05),PLT计数降低(P<0.05)。随着SIRS符合项数的增加,PT、TT、APTT延长,DD增加,PLT计数降低(P<0.01)。危重症组与非危重症组比较PT、TT、APTT延长,DD增加,PLT计数降低(P<0.01)。结论 SIRS新生儿存在凝血系统功能紊乱,符合SIRS诊断标准项数越多,新生儿危重病例评分越低,凝血功能紊乱越显著。

Objective To explore the change of coagulation function and its clinical significance in newborns with systemic inflammatory response syndrome （SIRS）. Methods 80 cases of newborns diagnosed as SIRS were divided into SIRS2 （having 2 iterms of the entry criterions for SIRS）, SIRS 3 （having 3 iterms of the entry criterions for SIRS） and SIRS 4 （having 4 itenns of the entry criterions for SIRS）. 50 cases with non - SIRS in the same period were divided into control group. All children were evaluated by the critical illness scoring during the 24hrs after hospitalized. According the score, all the cases were divided into the critical group （ ≤ 90 minutes） and non - critical group （ 〉 90% ）, 63 and 67 examples respectively. Take a blood sample during 24 h for testing prothrombin time （PT）, thrombin time （TT）, part of the activation thromboplastin time （APTT）, fibrinogen （FIB）, D- dimer （DD） and platelets （PLT）. Results SIRS group being com with control group, the content of D- dimer was increased sharply（ P 〈 0.05）, PT, APTT and TT are extended （ P 〈 0.05）, PLT count decreased （ P 〈 0.05）. With the number of items of SIRS increasing, PT, TT and APTT prolonged, DD raised, PLT decreased, and the difference were significantly（ P 〈 0.01 ）. Compared with non - critical group, the results in the critical group were the same, and the significant difference were observed（ P 〈 0.01 ）. Conclusion The newborns with SIRS have coagulation function disorder. The more items of criterions for SIRS, lower the critical score is, the more remarkable the coagulation function disorder is.