全身炎症反应综合征患者血清补体和抗凝血酶Ⅲ血浆D-二聚体的变化

Change of C_3 and C_4,AT-Ⅲ in serum and D-dimer quantity in plasma with SIRS

目的 探讨全身炎症反应综合征 (SIRS)患者血清补体 (C3 、C4)、AT -Ⅲ及血浆D -二聚体 (D -dimer)含量变化及其与SIRS病情严重程度和预后的关系。方法 用全自动免疫比浊定量分析法和酶联免疫吸附 (ELISA)法对 97例SIRS及32例非SIRS患者和 30例健康体检者血清补体C3 、C4、AT -Ⅲ及血浆D -dimer含量进行测定 ,并对SIRS患者不同住院时间的血清补体C3 、C4、AT -Ⅲ及血浆D -dimer含量进行测定。结果 SIRS组C3 、C4、AT -Ⅲ水平明显下降 ,D -dimer含量显著升高 ,与对照组和非SIRS组比较存在显著差异 (C3 、AT -Ⅲ、D -dimer:P均 <0 0 1,C4:P <0 0 5 ) ;SIRS组中病情好转者上述各指标随时间推移渐趋正常 ,至发生SIRS后第 7日上述各指标与正常对照组比较无明显差异 (P均 >0 0 5 ) ,而恶化组C3 、C4及AT-Ⅲ继续下降 ,D -dimer则进一步上升 ,与正常对照组比较存在显著差异 (P均 <0 0 1)。结论 SIRS患者存在血清补体 (C3 、C4)、AT -Ⅲ含量下降和血浆D -dimer含量升高 ,它们的变化与病情严重程度和预后相关。

ObjectiveTo investigate the clinical significance of changes in complement system and coagulation system in the patients with SIRS.Methods97 patients with SIRS were divided into non-infection-SIRS,sepsis,severe sepsis and sepsis shock group.The levels of C 3,C 4 and AT-Ⅲ were measured by photometry immune-turbidimetric test with automated biochemical analysis and the results were expressed as g/L,while the quantity of D-dimer was measured by enzyme linked immunosorbent assay.ResultsC 3,C 4 and AT-Ⅲ decreased but D-dimer markedly increased in SIRS group (C 3,AT-Ⅲ,D-dimer:all P<0.01.C 4:P<0.05);C 3,C 4,AT-Ⅲ and D-dimer returned to normal range in improvement group of SIRS on the 7th day after SIRS (all P<0.01).ConclusionC 3,C 4 and AT-Ⅲ decreased but D-dimer markedly increased in the patients with SIRS, which would be one of the useful indexes for judging the course and prognosis of patients with SIRS.