不同影像学表现的儿童肺炎支原体肺炎凝血常规测定的比较

Comparison of coagulation routine in children mycoplasma pneumoniae infection with different imaging manifestations

目的探讨凝血常规检测在影像学呈大叶性肺炎改变及普通肺炎改变的肺炎支原体肺炎(MPP)诊治中的临床意义。方法测定84例影像学呈大叶性肺炎改变的MPP患儿(大叶性肺炎组)、65例影像学呈普通肺炎改变的MPP患儿(普通肺炎组)的凝血常规,包括凝血酶原时间(PT)、PT国际标准化比值(INR)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原定量(FBG)、D-二聚体(DD)。同时测定66例健康体检儿童(对照组)的凝血常规值作对照。结果大叶性肺炎组血浆FBG定量及血浆DD定量[(3.55±0.86)g/L、(0.75±0.70)mg/L]较普通肺炎组[(3.29±0.84)g/L、(0.46±0.40)mg/L]及对照组[(2.50±0.63)g/L、(0.21±0.09)mg/L]高(P<0.05);普通肺炎组血浆FBG定量及血浆DD定量较对照组高(P<0.05)。三组之间TT、APTT、PT、INR两两比较,差异无统计学意义(P>0.05)。结论小儿肺炎支原体感染有可能激活机体凝血系统,引起或促进血栓形成,影像学呈大叶性肺炎表现的更为严重;对MPP患儿,应常规行凝血常规检查。

Objective To investigate clinical significance of coagulation routine detection in diagnosis of mycoplasma pneumoniae pneumonia（MPP） with imaging of lobar pneumonia change and common pneumonia change. Methods Detection was made on coagulation routine in 84 MPP children with imaging of lobar pneumonia change（lobar pneumonia group） and 65 MPP children with imaging of common pneumonia change（common pneumonia group）, including prothrombin time（PT）, PT international normalized ratio（INR）, activated partial thromboplastin time（APTT）, thrombin time（TT）, fibrinogen（FBG） and D-dimer（DD）. Coagulation routine in 66 healthy children（control group） was also taken into detection for comparison. Results The lobar pneumonia group had higher plasma FBG and DD contents [（3.55±0.86） g/L and（0.75±0.70） mg/L] than the common pneumonia group [（3.29±0.84） g/L and（0.46±0.40） mg/L] and the control group [（2.50±0.63） g/L and（0.21±0.09） mg/L]（P〈0.05）. The common pneumonia group had higher plasma FBG and DD contents than the control group（P〈0.05）. There was no statistically significant difference of TT, APTT, PT and INR between the three groups（P〈0.05）. Conclusion Children mycoplasma pneumoniae infection may activate coagulation system, cause or accelerate thrombosis, especially in cases with imaging of lobar pneumonia. Coagulation routine detection is necessary for MPP children.