【摘要】 目的探讨凝血系统紊乱在SIRS/MODS中的作用及其与SIRS/MODS严重程度的关系,为临床防治提供理论依据。方法采用发色底物法及酶联免疫吸附法(ELISA法)对43例SIRS患儿及19例非SIRS患儿血浆AT-Ⅲ活性、D-dimer含量进行检测,同时做DIC筛查。结果SIRS组与对照组和非SIRS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组(58.1%、69.8%VS15.7%、21.0%,P<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;SIRS未合并DIC时MODS的发生率为32.0%,合并DIC时MODS的发生率为83.3%(P<0.01)。结论SIRS患儿存在凝血纤溶功能异常,其在SIRS发展成MODS中具有重要作用。更多还原

【Abstract】 Objective To investigate the coagulation disorder in the children with SIRS and the relation to severity of SIRS/MODS,combining with the clinical screening of DIC,and provide evidences for the prevention and treatment of DIC.Methods The activity of AT-Ⅲ was measured by chromogenic substrate method.The quantity of D-dimer was measured by enzyme linked immunosorbent assay.Results The activity of AT-Ⅲ was lower and the quantity of D-dimer was significantly higher in SIRS group than that in non-SIRS and control groups.Abnormal rate of AT-Ⅲ and D-dimer was higher in SIRS group than that in non-SIRS group(58.1%,69.8% VS 15.7%,21.0%,P<0.05).Activity of AT-Ⅲ in SIRS group with MODS was lower than that in SIRS without MODS.The quantity of D-dimer of SIRS group with MODS was significantly higher than that of SIRS without MODS.The incidence of MODS in non-DIC children was 32.0%,and it was 83.3% in children with DIC(P <0.01).Conclusion Children with SIRS have abnormality in cougulation and fibrinolysis.It plays an important role in development from SIRS to MODS in severe patients.更多还原