CAJ | 학술논문

目的：探讨败血症新生儿凝血纤溶功能的变化及临床意义。方法选取该院新生儿科病房住院患儿86例，其中普通感染组30例，败血症组56例；另选择30例健康新生儿作为健康对照组。即时检测所有入选病例的血浆抗凝血酶Ⅲ（AT-Ⅲ）活性、D-二聚体（DD）水平和血小板（PLT）数量并进行分析。结果与健康对照组和普通感染组比较，败血症组 AT-Ⅲ活性和PLT 数量明显降低，DD 水平明显升高，差异有统计学意义（P ＜0．01），而健康对照组和普通感染组间三项指标比较差异无统计学意义（P ＞0．05）；败血症新生儿中弥散性血管内凝血（DIC）组的 AT-Ⅲ活性和 PLT 数量明显降低，DD 水平明显升高（P ＜0．01）， DIC 组三项指标同时异常的发生率为83．33％（15/18），明显高于非 DIC 组（χ2＝17．75，P ＝0．00）。结论新生儿败血症存在明显的凝血纤溶功能紊乱，并与患儿的病情严重程度有关，联合检测血浆 AT-Ⅲ活性、DD 水平和 PLT 数量变化有助于新生儿败血症时 DIC 的早期诊断。
목적：탐토패혈증신생인응혈섬용공능적변화급림상의의。방법선취해원신생인과병방주원환인86례，기중보통감염조30례，패혈증조56례；령선택30례건강신생인작위건강대조조。즉시검측소유입선병례적혈장항응혈매Ⅲ（AT-Ⅲ）활성、D-이취체（DD）수평화혈소판（PLT）수량병진행분석。결과여건강대조조화보통감염조비교，패혈증조 AT-Ⅲ활성화PLT 수량명현강저，DD 수평명현승고，차이유통계학의의（P ＜0．01），이건강대조조화보통감염조간삼항지표비교차이무통계학의의（P ＞0．05）；패혈증신생인중미산성혈관내응혈（DIC）조적 AT-Ⅲ활성화 PLT 수량명현강저，DD 수평명현승고（P ＜0．01）， DIC 조삼항지표동시이상적발생솔위83．33％（15/18），명현고우비 DIC 조（χ2＝17．75，P ＝0．00）。결론신생인패혈증존재명현적응혈섬용공능문란，병여환인적병정엄중정도유관，연합검측혈장 AT-Ⅲ활성、DD 수평화 PLT 수량변화유조우신생인패혈증시 DIC 적조기진단。
Objective To study the change and clinical significance of coagulation and fibrinolytic function in neonatal sepsis. Methods 86 neonates inpatients in the neonatology department of our hospital were selected and divided into the ordinary infection group(30 cases)and the sepsis group(56 cases),and 30 healthy neonates were selected as the normal control group.Plasma AT-Ⅲactivity,DD level and PLT count were detected immediately after admission and the detection results were analyzed.Results Com-pared with the control group and the ordinary infection group,the AT-Ⅲ activity and the PLT count in the sepsis group were sig-nificantly decreased,while the DD level was significantly increase,the difference had statistical significance(P <0.01).The differ-ences of the three indexes had no statistical significance between the normal control group and the ordinary infection group(P >0.05);however,the AT-Ⅲ activity and the PLT count in the DIC group were significantly decreased and the DD level was signifi-cantly increased(P <0.01),the occurrence rate of abnormal three indexes was 83.33%(15/18)in the DIC group,which was signifi-cantly higher than that in the non-DIC group(χ2 =17.75,P =0.00).Conclusion The obvious dysfunction of coagulation and fibri-nolysis exists in neonatal sepsis,which is related with the severity degree of disease.The joint detection of AT-Ⅲ activity,DD level and PLT count is helpful for the early diagnosis of DIC in neonatal sepsis.