58例川崎病患儿出凝血四项和D-二聚体的检测及分析

Study of blood coagulation and D-dimer in 58 patients with Kawasaki disease

目的探讨川崎病(KD)患儿治疗前后出凝血四项和D-二聚体的变化及其与冠状动脉损伤的关系。方法测定58例KD患儿出凝血四项,包括凝血酶原时间(PT)、部分凝血酶原活化时间(APTT)、凝血时间(TT)、纤维蛋白原定量(FIB)和D-二聚体(D-D),以及血小板计数(PLT),根据心脏彩超结果分为非冠状动脉损伤组(nCAL)和冠状动脉损伤组(CAL),并进行分析与评价。结果两组患儿治疗前PLT、FIB、D-D均高于正常,冠状动脉损伤组增高更明显,两组比较差异有统计学意义,治疗一周后PLT仍处于上升期,而FIB、D-D均较治疗前有所下降,但冠状动脉损伤组仍高于非冠状动脉损伤组,两组比较差异有统计学意义。结论 FIB、D-D是判断川崎病血液高凝状态及疗效的敏感指标。

Objective To study the changes of blood coagulation and D-dimer （D-D） in patients with Kawasaki disease （KD） and its relationship with coronary artery lesion （CAL）. Methods There were 58 KD children, 44 cases without CAL （nCAL） and 14 cases with CAL. Indexes including PT, TT, APTT, FIB, D-D and PLT were determined and compared between two groups. Results The levels of PLT, FIB and D-D in group of CAL was significantly higher than those in group of nCAL, there were significant decrease of FIB and D-D in two groups after treatment. Conclusion FIB and D-dimer can be used as a sensitivity index to judge hyperoagulability and curative effect in Kawasaki disease.