新生儿全身炎症反应综合征血浆ATⅢ、Ddimer水平探究.docVIP

新生儿全身炎症反应综合征血浆ATⅢ、Ddimer水平探究 　【摘要】 通过研究ATШ、Ddimer的水平，探讨新生儿凝血功能紊乱在全身炎症反应综合征/多器官功能障碍综合征（SIRS/MODS）中的表现。方法：对87例SIRS新生儿及40例非SIRS新生儿血浆ATⅢ活性、Ddimer含量进行检测。结果：SIRS组与正常对照组和非SIRS对照组比较，ATⅢ活性明显减低，Ddimer含量明显升高；SIRS组ATⅢ、Ddimer异常发生率明显高于非SIRS对照组（65.5%、56.3% vs 12.5%、10.0%，Plt;0.05）；SIRS合并MODS与SIRS未合并MODS者比较，ATⅢ活性明显减低，Ddimer含量明显升高；死亡组与存活组比较，ATⅢ活性明显减低，Ddimer含量明显升高。结论：SIRS新生儿存在凝血机制异常，合并MODS者，凝血功能紊乱越显著，病死率越高。 【关键词】 新生儿 全身炎症反应综合征 多器官功能障碍综合征 血浆抗凝血酶 D二聚体 ［Abstract］ Objective：To investigate the coagulation disorder in newborn infants with systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) by studying the level of antithrombin Ⅲ (ATⅢ) and Ddimer.Methods: The activity of ATⅢ was measured by chromogenic substrate method and the quantity of Ddimer was measured by enzyme linked immunosorbent assay in the 87 newborn infants with SIRS and 40 newborn infants without SIRS. Results:The activity of ATⅢ was lower and the quantity of Ddimer was higher significantly in SIRS group than that in nonSIRS and control group. Abnormal rate of ATⅢ and Ddimer was higher in SIRS group than that in nonSIRS group (65.5%, 56.3% vs 12.5%, 10.0%, Plt;0.05). Activity of ATⅢ in SIRS group with MODS was lower than that in SIRS group without MODS. The quantity of Ddimer of SIRS group with MODS was significantly higher than that of SIRS group without MODS. Conclusions: There are coagulation function disorder in the newborn with SIRS and more disorder and high mortality in those combined with MODS. 　　［Key words］ Newborn; Systemic inflammatory response syndrome(SIRS); Multiple organ dysfuntion syndrome(MODS); ATⅢ; Ddimer 全身炎症反应综合征（systemic inflammatory response syndrom，SIRS）是在感染或非感染因素作用下，机体炎症反应和抗炎症反应失衡的一种表现，是炎症、凝血和纤维蛋白溶解共同作用的结果［1］，进而发展成多脏器功能障碍综合征（multiple organ dysfunction syndrome，MODS）［2］。由于新生儿应激反应特别是免疫反应功能低下，故SIRS的发生率明显低于成人和儿童［3］，但新生儿由SIRS发展至MODS的比率及MODS的病死率均显著高于成人和儿童。目前有许多证据表明，在由SIRS发展到MODS整个过程中凝血机制异常起到很重要作用。因此，我们通过对有SIRS的新生儿的血浆抗凝血酶 Ⅲ（antithrombin