儿童凝血功能及凝血因子Ⅻ活性影响因素探讨

An Investigation into Influence Factors of Coagulation Function and FactorⅫin Chinese Children

目的探索儿童凝血功能及凝血因子Ⅻ活性(FⅫ:a)的影响因素。方法收集2017年1月至2019年7月,完成凝血功能四项及所有凝血因子活性检测的门诊或住院儿童资料。结果病例70例,男44例,女26例。男:女=1.7:1。年龄3月~14岁,中位年龄2.0岁。平均aPTT(35.3±4.6)s,aPTT值与年龄与性别无相关性(P=0.381,P=0.382)。aPTT>40 s的比例在免疫性疾病组、感染性疾病组、非感染性疾病组分别为42.9%、13.3%、6.3%。FⅫ:a平均为(42.8±16.2)%,FⅫ:a水平与年龄与性别无相关性(P=0.375、P=0.665)。FⅫ:a水平与aPTT呈负相关,r=-0.35,P=0.003。免疫性疾病组FⅫ:a明显低于感染性疾病组、非感染疾病组,分别为(31.7±9.4)%、(42.2±14.4)%、(44.3±17.1)%。结论儿童凝血功能及FⅫ:a受感染、免疫等多种因素影响,应建立中国儿童凝血功能及因子活性正常参考值,排除影响及干扰因素,避免误诊漏诊凝血异常疾病。

Objective To explore the influence factors of coagulation function and factorⅫin Chinese Children.Methods Plasma samples from outpatients/inpatients were tested for an activated partial thromboplastin time(aPTT),prothrombin time(PT),thrombin time(TT),Fibrinogen and all the coagulation factors activities,such as factorⅡ,Ⅴ,Ⅶ,Ⅹ,Ⅷ,Ⅸ,Ⅺ,Ⅻand vWF.Results Total of 70 children were enrolled,44 men,26 women,median age 2.0 years(3 months-14 years).The average aPTT was(35.3±4.6)seconds.No significant correlation was seen between APTT values and age or gender(P=0.381,P=0.382).The rate of abnormal aPTT is significantly higher in the group of immune diseases than those in the groups of infection diseases and non-infection diseases,42.9%、13.3%、6.3%respectively.The average activity of FⅫin the 70 Chinese children was(42.8±16.2)%.No significant correlation was seen between FⅫI:C and age or gender(P=0.375,P=0.665).There was weak negative correlation between FⅫ:C and aPTT(r=-0.35,P=0.003).The activity of FⅫin the group of immune diseases was lower than those in the groups of infection diseases and non-infection diseases,(31.7±9.4)%,(42.2±14.4)%and(44.3±17.1)%respectively.Conclusion Infection and immunity might influent coagulation function and factorⅫin children.To avoid misdiagnosis or missed diagnosis,it should be necessary to establish the normal range of factorⅫactivity in healthy Chinese children and exclude the influence factors.