CAJ | 학술논문

目的：探讨脓毒症患儿凝血功能指标与新生儿危重评分的相关性。方法选取2010年1月—2014年12月在该院新生儿住院的脓毒症患儿共93例，按新生儿危重病例评分法将患儿分为非危重组、危重组和极危重组。对入组的患儿在入院时及经治疗后72 h 采集患儿静脉血分别测定外周血中血小板（PLT）、凝血酶时间（TT）、活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）、纤维蛋白原（FIB）、D-二聚体（DD）、抗凝血酶Ⅲ（AT-Ⅲ）和蛋白质 C（PC）。采用统计软件分析和比较非危重组、危重组和极危重组三组患儿治疗前后各项凝血指标的动态变化情况。结果与非危重组比较，危重组、极危重组 TT 、PT、APTT延长（P ＜0．05），DD、FIB 水平升高（P ＜0．05），PC、AT-Ⅲ和 PLT 水平显著性降低（P ＜0．05）。与危重组比较，极危重组 PC、AT-Ⅲ和 PLT 水平显著性降低（P ＜0．05），DD 水平升高（P ＜0．05），PT、APTT、TT、FIB 两组比较差异无统计学意义（P ＞0．05）。与急性期比较，危重和极危重组患儿经治疗好转后，恢复期 TT 、PT、APTT 缩短（P ＜0．05），DD、FIB 水平降低（P ＜0．05），PC、AT-Ⅲ和 PLT 水平升高（P ＜0．05）；而非危重组凝血功能指标变化均无统计学差异。结论脓毒症患儿的凝血功能的异常与危重评分之间密切相关，与疾病的发展进程和预后密切相关。
목적：탐토농독증환인응혈공능지표여신생인위중평분적상관성。방법선취2010년1월—2014년12월재해원신생인주원적농독증환인공93례，안신생인위중병례평분법장환인분위비위중조、위중조화겁위중조。대입조적환인재입원시급경치료후72 h 채집환인정맥혈분별측정외주혈중혈소판（PLT）、응혈매시간（TT）、활화부분응혈활매시간（APTT）、응혈매원시간（PT）、섬유단백원（FIB）、D-이취체（DD）、항응혈매Ⅲ（AT-Ⅲ）화단백질 C（PC）。채용통계연건분석화비교비위중조、위중조화겁위중조삼조환인치료전후각항응혈지표적동태변화정황。결과여비위중조비교，위중조、겁위중조 TT 、PT、APTT연장（P ＜0．05），DD、FIB 수평승고（P ＜0．05），PC、AT-Ⅲ화 PLT 수평현저성강저（P ＜0．05）。여위중조비교，겁위중조 PC、AT-Ⅲ화 PLT 수평현저성강저（P ＜0．05），DD 수평승고（P ＜0．05），PT、APTT、TT、FIB 량조비교차이무통계학의의（P ＞0．05）。여급성기비교，위중화겁위중조환인경치료호전후，회복기 TT 、PT、APTT 축단（P ＜0．05），DD、FIB 수평강저（P ＜0．05），PC、AT-Ⅲ화 PLT 수평승고（P ＜0．05）；이비위중조응혈공능지표변화균무통계학차이。결론농독증환인적응혈공능적이상여위중평분지간밀절상관，여질병적발전진정화예후밀절상관。
Objective To explore the relationship between coagulation function indexes and critical illness scoring in newborns with sepsis.Methods The data of sepsis occurrence in 93 newborns hospitalized in Luohe Second People’s Hospital during January 2010 and December 2014 were analyzed retrospectively.According to the neonatal critical illness scoring,93 newborns were assigned into 3 groups:non -critical illness group,critical illness group and very critical illness group.The platelets (PLT)count,activation part thro-moplastin time (APTT),prothrombin time (PT),thrombin time (TT),fibrinogen (FIB),antithrombinⅢ (AT-Ⅲ),protein C (PC) and D -dimer (DD)in the blood were tested after admission or 72h after treatment.Statistical analysis was made of the indexes of co-agulation function among the 3 groups,and the dynamic changing process of coagulation function were compared before and after treat-ment.Results Compared with the non -critical illness group,PLT,AT-Ⅲ and PC of other groups were significantly lower (P <0.05),while APTT,PT,TT,DD and FIB were significantly raised.However,the differences in PT,APTT,TT and FIB were not signifi-cant (P >0.05)in the critical illness group and very critical illness group.After the treatment,the PLT,AT-Ⅲ and PC of all groups were significantly higher (P <0.05),while APTT,PT,TT,DD and FIB were significantly lower.Conclusion The abnormal coagula-tion function was intimately correlated with the critical score,disease progression and prognosis of newborns with sepsis.