血浆组织蛋白酶S和血小板反应蛋白-1对新生儿弥散性血管内凝血的早期诊断价值

Value of plasma cathepsin S and thrombospondin-1 in early diagnosis of neonatal disseminated intravascular coagulation

目的分析血浆组织蛋白酶S(Cat S)、血小板反应蛋白-1(TSP-1)对新生儿弥散性血管内凝血(DIC)的早期诊断价值。方法选择50例DIC患儿为DIC组,另外选择同期凝血功能正常的48例新生儿为对照组。比较2组新生儿血浆Cat S、TSP-1及凝血功能指标水平,分析血浆Cat S、TSP-1、凝血功能指标水平与新生儿DIC发生的相关性,观察其对新生儿DIC的诊断效能。结果治疗前,DIC组血浆Cat S、TSP-1、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)及D-二聚体(D-D)水平高于、长于对照组,血小板(PLT)低于对照组,差异有统计学意义(P<0.05);治疗后,DIC组患儿血浆Cat S、TSP-1、APTT、PT及D-D水平低于、短于治疗前,差异有统计学意义(P<0.05);血浆Cat S、TSP-1、APTT、PT及D-D与新生儿DIC的发生呈正相关(P<0.001),PLT与新生儿DIC的发生呈负相关(P<0.001)。结论血浆Cat S、TSP-1对新生儿DIC有一定的诊断价值,两者联合诊断效能较高。

Objective To analyze the value of plasma cathepsin S(Cat S) and thrombospondin-1(TSP-1) in early diagnosis of neonatal disseminated intravascular coagulation(DIC). Methods Fifty DIC neonate patients were selected as DIC group, and 48 neonates with normal coagulation function during the same period were selected as control group. The plasma Cat S, TSP-1 and coagulation function levels of neonates in the two groups were compared, and the correlations of the levels of plasma Cat S, TSP-1 and coagulation function indexes with occurrence of neonatal DIC were analyzed, and their diagnostic efficacy for neonatal DIC was observed. Results Before treatment, levels of plasma Cat S, TSP-1, D-dimer(D-D), activated partial thrombin time(APTT) and prothrombin time(PT) were higher and longer than those in the control group, while platelet(PLT) level in the DIC group was lower than those in the control group, the differences were statistically significant(P<0.05). After treatment, the levels of plasma Cat S, TSP-1, APTT, PT and D-D in the DIC group were lower than before treatment(P<0.05);the plasma Cat S, TSP-1, APTT, PT and D-D were positively correlated with occurrence of neonatal DIC, and PLT was negatively correlated with DIC in neonates(P<0.001). Conclusion Plasma Cat S and TSP-1 have a certain diagnostic value for neonatal DIC. The combination of Cat S and TSP-1 has high diagnostic efficiency.