血清补体活性和D-二聚体含量及血小板计数与SIRS的预后.docVIP

血清补体活性和D-二聚体含量及血小板计数与SIRS的预后 　　作者：汪江萍 严越秀 汤鸣 乔萍 作者单位：广东省肇庆市第一人民医院儿科，广东 肇庆 526021 　　【摘要】目的 探讨全身炎症反应综合征(SIRS)患儿血清补体(C3、C4)活性、D-二聚体含量、血小板计数变化的临床意义。方法 采用全自动免疫比浊定量分析法和全自动血细胞计数仪测定48例SIRS患儿和40例非SIRS患儿的血清C3、C4、D-二聚体含量和血小板计数及其动态变化。结果 SIRS患儿首次测定的血清C3、C4、D-二聚体含量和血小板计数均显著高于非SIRS患儿组(P0.01)。动态观察发现：SIRS组病情好转后4项参数均较好转前低(P0.01或0.05)，而恶化组D-二聚体含量持续升高，C3、C4和血小板计数持续下降，明显不同于好转前(P0.05或0.01)。而且病情恶化组SIRS患儿病情变化后C3、C4和血小板计数均低于好转组，D-二聚体含量则高于好转组(P0.05或0.01)，但病情变化前两组四项指标差异无显著性(P0.05)。结论 C3、C4、D-二聚体含量、血小板计数的测定有助于判断SIRS患儿的预后。 　　【关键词】 全身炎症反应综合征 婴儿 补体 血小板计数 D-二聚体 　　Serum complement，D-dimer and platelet count in predicting systemic inflammatory response syndrome 　　WANG Jiang-ping，YAN Yue-xiu，TANG Ming，QIAO Ping 　　(Department of Pediatrics，Zhaoqing First Peoples Hospital，Zhaoqing，Guangdong 526021，P.R.China) 　　Abstract： Objective To outline the clinical significances of serum complement 3 and 4 (C3 and C4)，platelet count and D-dimer in infants with systemic inflammatory response syndrome (SIRS). Methods The levels of C3，C4 and D-dimer were measured by photometry immuno-turbidimetric test with automated biochemical analysis，and the platelet count was determined by automated blood cells counter in 48 infants with SIRS and 40 infants without SIRS. Results The levels of C3，C4 and D-dimer in infants with SIRS were higher by comparison with those in infants without SIRS，there were statistically significant differences (P0.01).Dynamic observation found： in infants with SIRS group，the above four indexes in cases with symptom relief were lower than before，there were statistically significant differences (P0.01 or 0.05).In infants in admission to PICU，the D-dimer consistently elevated，C3，C4 and platelet count consistently decreased，significantly differed from that time with symptom relief (P0.05 or 0.01); moreover，in infants in admission to PICU，levels of C3，C4 and platelet count were lower，D-dimer was higher，by comparison with infants with symptom relief (P0.05 or 0.01); before the dise