急性呼吸窘迫综合征早产患儿血浆D-二聚体及降钙素原检测的临床意义

Clinical significance of plasma D-Dim er and calcitonin original level detection in premature infants with acute respiratory distress syndrome

目的:探讨血浆D-二聚体及降钙素原检测在早产患儿急性呼吸窘迫综合征的临床意义。方法:选取2011年1月至2014年1月大埔县人民医院收治的急性呼吸窘迫综合征早产患儿66例作为观察组,另选取30例同期健康早产儿作为对照组。分别采用酶联免疫法和免疫化学发光法检测两组血浆D-二聚体及降钙素原水平,统计两组APACHEII评分、死亡情况并分析患儿血浆D-二聚体及降钙素原与其APACHEII评分、死亡情况的关系。结果:观察组确诊时、治疗1d、3d、5d和7d后的血浆D-二聚体及降钙素原水平均高于对照组,且观察治疗5d和7d后的血浆D-二聚体及降钙素原水平均较确诊时降低,差异有统计学意义(P<0.05)。观察组确诊时、治疗1d、3d、5d和7d的APACHEII评分分别为(24.48±4.78)分、(21.24±4.69)分、(18.67±4.56)分、(16.78±3.24)分和(16.66±2.37)分,均高于对照组的(13.34±4.34)分、(12.45±4.64)分、(11.75±3.54)分、(11.47±4.09)分和(11.26±3.78)分;观察组死亡率亦显著高于对照组,差异有统计学意义(P<0.05)。与存活患儿比较,观察组死亡患儿血浆D-二聚体及降钙素原水平和APACHEII评分均较高,差异有统计学意义(P<0.05)。结论:急性呼吸窘迫综合征早产患儿血浆D-二聚体、降钙素原水平及APACHEII评分较高,急性呼吸窘迫综合征早产患儿出现血浆D-二聚体及降钙素原水平升高的需警惕其病情的变化和不良预后的发生。

Objective： To investigate the clinical significance of plasma D-dimer and calcitonin original level in premature infants with acute respiratory distress syndrome. Methods： 66 premature infants with acute respiratory distress syndrome in our hospital from Jan 2011 to Jan 2014 were selected as the observation group,another 30 cases of healthy premature infants in the same period were selected as the control group. Enzyme-linked immunoassay detection and immunochemiluminescence assays were respectively used to detect plasma D- dimer and calcitonin original level of two groups. APACHEII scores, death rate,plasma D-dimer, calcitonin original, APACHEII scores of survival children and dead children in different time were statistically analyzed in two groups in which the relationship between plasma D- dimer ,calcitonin original, APACHEII scores and death rate were also analyzed. Results： Average plasma D-dimer and calcitonin original level of observation group in diagnosis and after treated with ld, 3d, 5d and 7d were higher than that of the control group, and plasma D- dimer and calcitonin original level of observation group after treated with 5d and 7d were lower than that of in diagnose in which the differences were statistically significant （P〈0.05）. APACHEI1 scores of observing group in diagnosis and after treated with ld, 3d, 5d and 7d were （24.48±4.78）, （21.24±4.69）, （18.67±4.56）, （16.78±3.24） and （16.66±2.37） points respectively, which were higher than the （13.34±4.34）, （12.45±4.64）, （11.75±3.54）, （11.47±4.09） and （11.26±3.78） point of the control group. Mortality rate of observation group was also significantly higher than that of the control group in which the difference was statistically significant （P〈0.05）. Compared with survived children, plasma D-dimer, caleitonin original level and APACHEII scores of dead children were higher, and the difference was statistically significant（P〈0.05 ） between survived children and dead children. Conclusions： Plasma D - dimer and calcitonin original levels in premature infants with acute respiratory distress syndrome are increased and related with APACHEII scores and mortality rate, thus premature infants with acute respiratory distress syndrome, high plasma D-dimer and ealeitonin original levels should be alert to the worsefi of the disease condition and poor prognosis.