【摘要】 【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。更多还原

【Abstract】 Objectives]To find out the experimental markers for diagnosis of pre-disseminated intravascular coagulation (pre-DIC) state in children.The plasma level of antithrombin Ⅲ (AT-Ⅲ) was estimated by method of chromophore substrate (immune turbidimetry) and plasma levels of thrombin-antithrombin Ⅲ complex(TAT), tissue factor (TF) and tissue factor pathway Inhibitor (TFPI) were estimated by ELISA techniques.In the group of children with DIC(n=17), the plasma levels of TAT and TF increased significantly (for TF:P<0.01 , for TAT: P<0.05), but those of AT-Ⅲ decreased obviously (P<0.01) , of FTPI decreased slightly (P>0.05) as compared with the controls(n=18). As for the group of children with pre-DIC state(n=28), the plasma levels of TAT and TF increased distinctly (P<0.01), while plasma level of AT-Ⅲ declined significantly(P<0.01). The positive detection rates of AT-Ⅲ, TAT and TF in DIC group were 88.2%, 94.1% and 94.1% respectively, showing sensitivities higher than those of other experimental markers. The positive detection rate of TFPI was 58.8% ; whereas the positive detection rates of AT-Ⅲ, TAT and TF in pre-DIC group were 82.1%, 92.9% and 78.6% respectively , their sensitivities were also better than those of other experimental markers. The positive rate of TFPI was only 10.7%.[Conclusion]Molecular markers AT-Ⅲ, TAT and TF can early reflect the activating state of the blood coagulation and anti-coagulation system in vivo. They possess important value in the diagnosis of children DIC, especially for children in pre-DIC state.更多还原