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目的探讨重症肺炎(SCAP)患儿降钙素原(PCT)与凝血纤溶指标的变化与临床意义。方法选取2012年3月至2015年7月廊坊市第四人民医院儿童重症监护病房治疗的儿童SCAP患者92例(SCAP组),根据血清PCT水平将SCAP组患者分为高PCT组(血清PCT≥2.00 ng/ml)与低PCT组(血清PCT<2.00 ng/ml)。对照组为无感染性疾病的儿童患者54例。检测和比较各组PCT水平与血小板计数(BPC)、抗凝血酶Ⅲ活性(AT-Ⅲ:C)及D-二聚体(D-dimer,D-D)等的变化情况。结果与对照组比较,SCAP组BPC、D-D、PCT水平明显升高,AT-Ⅲ:C明显降低(P<0.01);高PCT组的BPC及AT-Ⅲ:C水平明显低于低PCT组,而D-D明显高于低PCT组(P<0.01或P<0.05)。高PCT组弥散性血管内凝血的发生率明显高于低PCT组(P<0.05)。结论重症肺炎患儿存在凝血功能紊乱和PCT水平升高,PCT水平与凝血功能紊乱有关。
Objective To investigate the changes and clinical significance of procalcitonin (PCT) and coagulation and fibrinolysis in children with severe pneumonia (SCAP). Methods From March 2012 to July 2015, 92 children with SCAP in SCI from the Fourth People’s Hospital of Langfang City were enrolled. SCAP patients were divided into high PCT group (serum PCT> 2.00 ng / ml) and low PCT group (serum PCT <2.00 ng / ml). The control group was non-infectious disease in 54 cases of children. The changes of PCT and platelet count (BPC), antithrombin Ⅲ activity (AT-Ⅲ: C) and D-dimer (D-D) were detected and compared among the three groups. Results The levels of BPC, DD and PCT in SCAP group were significantly higher than those in control group (P <0.01). The levels of BPC and AT-Ⅲ: C in high PCT group were significantly lower than those in low PCT group While DD was significantly higher than the low PCT group (P <0.01 or P <0.05). The incidence of disseminated intravascular coagulation in the high PCT group was significantly higher than that in the low PCT group (P <0.05). Conclusion There are coagulation disorders and PCT levels in children with severe pneumonia. PCT levels are associated with coagulation disorders.