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【目的】探索儿童DIC前状态诊断的实验指标。【方法】用发色底物法测定血浆抗凝血酶Ⅲ (AT Ⅲ ) ,用ELISA法测定血浆凝血酶 抗凝血酶Ⅲ复合物 (TAT)、组织因子 (TF)、组织因子途径抑制物 (TFPI)。【结果】在DIC组 (n =17) ,患儿TAT、TF含量显著升高 ,AT Ⅲ含量显著降低 ,FTPI含量稍降低 ,与正常对照组 (n =18)比较 ,TF、AT Ⅲ差异有显著性 (P <0 .0 1) ,TAT差异有显著性 (P <0 .0 5 ) ,而TFPI差异无显著性。在DIC前状态组 (n =2 8) ,患儿TAT、TF含量显著升高 ,AT Ⅲ含量显著降低 ,与正常对照组比较 ,差异有极显著性意义 (P <0 .0 1) ,TFPI差异无显著意义。在DIC组 ,AT Ⅲ、TAT、TF检测阳性率分别为 88.2 %、94 .1%、94 .1% ,敏感性高于其他常规实验指标。TFPI检测阳性率为 5 8.8%。在DIC前状态组AT Ⅲ、TAT、TF检测阳性率分别为 82 .1%、92 .9%、78.6 % ,敏感性高于其他常规实验指标。TFPI检测阳性率仅 10 .7%。【结论】分子标志物AT Ⅲ、TAT及TF能早期反映体内凝血及抗凝血系统的激活 ,在DIC特别是DIC前状态的诊断中有重要价值。
【Objective】 To explore the experimental indicators of pre-DIC diagnosis in children. 【Method】 Plasma antithrombin Ⅲ (AT Ⅲ) was measured by chromogenic substrate method. Plasma thrombin antithrombin Ⅲ complex (TAT), tissue factor (TF), tissue factor pathway inhibitor (TFPI). 【Results】 In DIC group (n = 17), the levels of TAT and TF in children were significantly increased, the content of AT Ⅲ was significantly decreased and the content of FTPI was slightly decreased. Compared with normal control group (n = 18) Significant (P <0. 01), TAT difference was significant (P <0. 05), while the TFPI difference was not significant. In the pre-DIC group (n = 28), the levels of TAT and TF were significantly increased and the content of AT Ⅲ was significantly decreased in children with TICI (P <0.01). Compared with the normal control group, No significant difference. In DIC group, the positive rates of AT Ⅲ, TAT and TF were 88.2%, 94.1% and 94.1%, respectively. The sensitivity was higher than other routine experimental indexes. TFPI test positive rate of 5 8.8%. The positive rates of AT Ⅲ, TAT and TF in pre-DIC group were 82.1%, 92.9% and 78.6%, respectively, which were higher than those of other routine experimental indexes. TFPI test positive rate of only 10.7%. 【Conclusion】 The molecular markers AT Ⅲ, TAT and TF can early reflect the activation of coagulation and anticoagulant system in vivo, which is of great value in the diagnosis of DIC, especially the pre-DIC state.