【摘要】 目的　探讨重症肺炎合并高凝状态的实验室诊断标准及评价肝素抗凝治疗有效的实验室指标。方法　测定2 0 0 1年1 0月至2 0 0 3年6月佛山市顺德妇幼保健院和顺德杏坛医院收治的52例重症肺炎患儿治疗前后的D -二聚体(D -Dimer)、抗凝血酶Ⅲ(AT Ⅲ)、凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血时间(APTT)、纤维蛋白原(Fbg)及氧饱和度(SaO2 ) ,并进行对比。结果　52例重症肺炎患儿中2 0例的D- Dimer升高,治疗前3 2例患儿的AT Ⅲ活性及SaO2 明显降低,TT、APTT明显缩短。经肝素治疗后,2 0例治疗组患儿的D- Dimer下降、SaO2 升高、TT延长、Fbg下降。结论　重症肺炎存在高凝状态,其实验室诊断参考指标是:D- Dimer升高、AT Ⅲ降低、TT、APTT缩短。评价肝素抗凝治疗有效的实验室指标是:D -Dimer下降,AT Ⅲ活性>70 % ,TT、PT、APTT延长,Fbg下降。更多还原

【Abstract】 Objective To explore the laboratory diagnosis criteria of hypercoagulable state of severe pneumonia and the laboratory evaluating indexes of effective anticoagulation treatment with heparin. Method D-Dimer、ATⅢ、TT、PT、APTT、Fbg and SaO 2 levels were measured and compared in severe pneumonia before and after treatment with heparin.Results D-Dimer level was increased in 20 of 52 cases of severe pneumonia patients.In 32 patients with severe pneumonia before treatment with heparin,ATⅢ and SaO 2 levels were significantly lower and TT、APTT were remarkably shorter than that in normal control group.In 20 patients with severe pneumonia after treatment with heparin,D-Dimer and Fbg levels were significantly reduced,while SaO 2 and TT levels were obviously increased. Conclusions There exists hypercoagulable state in severe pneumonia.Its laboratory diagnosis criteria are D-Dimer level higher、ATⅢ level lower and TT、APTT shorter than that in normal control group;The laboratory evaluating indexes of effective anticoagulation treatment with heparin are D-Dimer and Fbg levels reduced,the activity of ATⅢ more than 70%,and TT、PT、APTT longer respectively after treatment with heparin.更多还原