乳酸与凝血功能障碍对危重患儿预后的影响

Influence of serum lactic acid and coagulation dysfunction on prognosis in critically ill children patients

目的研究血乳酸、凝血功能障碍与小儿危重病例评分的关系,及二者对危重患儿预后的影响。方法选取儿童重症监护室(PICU)收治的80例危重患儿资料,按危重病评分(PCIS)标准分为非危重组(n=18)、危重组(n=30)、极危重组(n=32)。比较乳酸、凝血功能指标在不同危重程度患儿中的差异,并进行单因素相关分析、多元线性回归分析。结果随着PCIS的下降,危重患儿病情逐渐加重,休克、多器官功能障碍综合征发生率明显升高。入PICU乳酸值、乳酸峰值、血浆凝血酶原时间、活化部分凝血激酶时间、凝血酶时间、纤维蛋白原与PCIS有显著的线性相关。结论乳酸、凝血功能障碍与PCIS有良好的相关性,二者联合是预测危重患儿预后较敏感的指标。

Objective To investigate the correlation between serum lactic acid （LA） and coagulation dysfunction with pediat- ric critical score （PCIS） and their influence on prognosis in critically ill children patients. Methods Eighty critically ill children pa- tients in the pediatric intensive care unit （PICU）were enrolled and divided into the non-critical （n=18）, critical （n= 30） and ex- tremely critical groups （n=32） according to the PCIS standard. Lactic acid （LA） and coagulation function parameters were com- pared among the three groups. The single factor correlation analysis and multiple linear regressive analysis were performed. Results With PCIS decrease, the condition of critically ill children patients was gradually aggravated, the occurrence rates of shock and multiple organ dysfunction syndrome（MODS） were significantly increased. There were significant linear correlation between the lactic acid level,peak lactic acid level,PT,APTT,TT and FBG in PICU with PCIS respectively. Conclusion There is a good corre- lation between serum LA and coagulation dysfunction with PCIS. The combination of serum LA and coagulation dysfunction can be used as a more sensitive indicator for predicting th eprognosis in critically ill children patients.