摘要
目的观察败血症新生儿血栓调节蛋白(TM)和D-二聚体(DD)的变化,探讨二者在败血症新生儿病情评估及预后判断中的意义。方法将56例败血症新生儿进行新生儿危重病例评分,分为极危重组(13例)、危重组(22例)和非危重组(21例),在入院初期及恢复期采空腹静脉血,应用酶联免疫吸附试验测定血浆TM,应用免疫比浊法测定血浆DD。26例健康新生儿作为对照组。比较各组血浆TM和DD的差异及败血症新生儿治疗前后二者的变化。结果败血症极危重组、危重组、非危重组新生儿血浆TM水平分别为25.5±6.6、17.3±4.7、13.3±2.8μg/L,较对照组的9.8±2.7μg/L明显升高(P<0.01)。败血症极危重组、危重组新生儿血浆DD水平分别为744±262、436±147μg/L,较对照组的205±61μg/L明显升高(P<0.01)。非危重组、危重组、极危重组3组血浆TM和DD水平依次升高(P<0.05)。治疗后(恢复期)患儿血浆TM和DD水平显著下降,与治疗前比较差异有统计学意义(P<0.01)。血浆TM和DD水平与新生儿危重评分均呈明显负相关(分别r=-0.428、-0.363,P<0.01)。结论检测败血症新生儿的血浆TM和DD水平有助于评估病情危重程度及预后。
Objective To observe changes in plasma thrombomodulin （TM） and D-dimer （DD） levels in neonates with sepsis, and to investigate their significance in evaluating the patients＇ condition and prognosis. Methods Fifty- six neonates with sepsis were classified into extremely critical （n=13）, critical （n=22） and non-critical groups （n=21） based on neonatal critical illness score （NCIS）. Fasting venous blood samples were collected on admission and in the recovery phase. Plasma TM and D-dimer levels were measured using enzyme-linked immunosorbent assay and immune turbidimetry, respectively. Twenty-six healthy neonates were selected as the control group. Plasma TM and D-dimer levels were compared between groups, and the changes after treatment were determined. Results Plasma TM levels in the extremely critical, critical and non-critical groups were 25.5±6.6, 17.3±4.7 and 13.3±2.8 μg/L respectively, significantly higher than in the control group （9.8±2.7 μg/L） （P〈0.01）. Plasma D-dimer levels in the extremely critical and critical groups were 744±262 and 436±147 μg/L respectively, also significantly higher than in the control group （205±61 μg/L） （P〈0.01）. The extremely critical group had significantly higher plasma TM and DD levels than the critical group （P〈0.05）, and the critical group had significantly higher plasma TM and DD levels than the non-critical group （P〈0.05）. All patients showed significant decreases in plasma TM and DD levels in the recovery phase after treatment （P〈0.01）. Plasma TM and DD levels were significantly negatively correlated with NCIS （r = -0.428, P〈0.01; r = -0.363, P〈0.01）. Conclusions Determination of plasma TM and DD levels may be helpful in evaluating severity and prognosis in neonates with sepsis.
出处
《中国当代儿科杂志》
CAS
CSCD
北大核心
2013年第10期841-844,共4页
Chinese Journal of Contemporary Pediatrics
基金
河北省卫生厅2010年医学科学研究重点课题计划(项目编号:20100251)
