目的：探讨重症肺炎患儿血小板参数和凝血指标的变化及其临床价值。方法选取重症肺炎患儿97例，根据是否合并呼吸系统以外的其他系统疾病，将患儿分为重症肺炎Ⅰ组和重症肺炎Ⅱ组，同时，选取30例健康儿童作为对照组，比较3组儿童血小板参数[血小板计数（PLT）、平均血小板体积（MPV）]和凝血指标[凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）、抗凝血酶Ⅲ（AT-Ⅲ）和 D-二聚体（DD）]情况。结果3组间 PLT、MPV、DD 和 AT-Ⅲ活性比较，差异均有统计学意义（均 P ＜0．05）。重症肺炎Ⅰ组 PLT、MPV、DD 分别为（454．00±157．00）×109／L、（9．66±1．24）fL、（0．47±0．37）mg／L，均高于对照组[分别为（300．00±63．00）×109／L、（8．90±0．37）fL、（0．27±0．06）mg／L]；AT-Ⅲ活性低于对照组[（79．91±20．34）％ vs（107．03±8．11）％]，差异均有统计学意义（均 P ＜0．05）。重症肺炎Ⅱ组 AT-Ⅲ和 PLT 水平分别为（66．11±11．12）％、（279．00±185．00）×109／L 低于重症肺炎Ⅰ组，MPV 和 DD 水平分别为（10．37±1．51）fL、（0．70±0．46）mg／L，均高于重症肺炎Ⅰ组，差异均有统计学意义（均 P＜0．05）。结论重症肺炎患儿存在明显的凝血功能紊乱，PLT、MPV、AT-Ⅲ和 DD 水平变化与患儿的病情严重程度有关。%Objective To study the changes and clinical value of platelet(PLT)parameters and coagulation indicators in children with severe pneumonia.Methods 97 children were divided into severe pneumonia groupⅠand severe pneumonia groupⅡ according to whether children were associated with other diseases besides severe pneumonia,and 30 healthy chil-dren were in control group.The levels of PLT count,mean platelet volume(MPV),prothrombin time(PT),activated par-tial thromboplastin time(APTT),fibrinogen(FIB),antithrombin-Ⅲ(AT-Ⅲ),and D-dimer(DD)among three groups were compared.Results The differences of PLT,MPV,DD and AT-Ⅲ activities were all significant among three groups (all P < 0.05).PLT,MPV and DD levels in group Ⅰ were all significantly higher than those of control group ([454.00±157.00]×109/L vs [300.00±63.00]×109/L ;[9.66±1.24]fL vs [8.90±0.37]fL;[0.47±0.37] mg/L vs [0.27±0.06]mg/L,respectively);AT-Ⅲ activity in groupⅠ was lower than control group([79.91 ± 20.34]% vs[107.03±8.11]%)(both P <0.05).AT-Ⅲ activity and PLT level in group Ⅱwas (66.11±11.12)%and (279.00±185.00)×109/L respectively,which were both significantly lower than group Ⅰ,MPV and DD level was (10.37± 1.51)fL and (0.70±0.46)mg/L respectively,which were both higher than groupⅠ (both P <0.05).Conclusion There is obvious coagulation dysfunction in children with severe pneumonia.The changes in PLT,MPV,AT-Ⅲ and DD levels are associated with the severity of pneumonia.
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