摘要
目的:探讨D-二聚体(DD)/FDP比值对新生儿弥散性血管内凝血前期(preDIC)的诊断及治疗意义。方法:对NICU收治的96例危重新生儿中符合preDIC临床诊断标准的48例(preDIC组)和DIC的48例(DIC组)及50例正常新生儿(对照组)检测其血清中DD、FDP及DD/FDP的水平,以及应用小剂量肝素后preDIC组和DIC组血清中DD、FDP、DD/FDP的水平变化。结果:preDIC组和DIC组中DD、FDP均有明显升高,与对照组比较差异有统计学意义(P<0.05),preDIC组和DIC组比较差异无统计学意义(P>0.05);preDIC组中DD/FDP比值较DIC组比值明显升高,差异有统计学意义(P<0.05);应用小剂量肝素后,preDIC组与DIC组中DD、FDP水平均明显下降,两组比较差异无统计学意义(P>0.05);preDIC组中DD/FDP明显下降,肝素应用前后比较差异有统计学意义(P<0.05),DIC组前后比较差异无统计学意义(P>0.05)。结论:在DIC前期,凝血系统和纤溶系统均已发生明显改变,且凝血功能明显要高于其纤溶功能,故监测DD/FDP比值有助于DIC前期的诊断;在应用小剂量肝素后比值明显下降,有助于早期阻止DIC的发生。
Objective： To explore the significance of the ratio of D - dimer to FDP in diagnosis and treatment of neonatal pre - dis- seminated intravascular coagulation （ pre - DIC）. Methods ： The levels of D - dimer and FDP, the ratio of D - dimer/FDP in serum of 48 severe neonates with pre -DIC （pre -DIC group）, 48 severe neonates with DIC （DIC group）, and 50 normal neonates （control group） were detected, the severe neonates in pre - DIC group and DIC group were selected from NICU of the hospital, the changes of serum D - dimer and FDP levels, the ratio of D - dimer/FDP in pre - DIC group and DIC group after treated with low - dose heparin were detected. Results ： In pre - DIC group and DIC group, the levels of D - dimer and FDP increased significantly, compared with control group, there was significant difference （ P 〈 O. 05 ）, there was no significant difference between pre - DIC group and DIC group （ P 〉 0. 05 ） ; compared with DIC group, the ratio of D - dimer/FDP in pre - D1C group increased significandy （ P 〈 0. 05 ） ; after treated with low - dose heparin, the levels of D - dimer and FDP in pre - DIC group and DIC group decreased significantly, there was no significant difference between the two groups （ P 〉 0. 05 ） ; the ratio of D - dimer/FDP in pre - DIC group decreased significantly, there was significant difference before and after treat- ment （ P 〈 0. 05 ） ; while in DIC group, there was no significant difference before and after treatment （ P 〉 0. 05 ）. Conclusion ： Coagulation system and fibrinolytic system change significantly among the neonates with pre - DIC, and the change of coagulation system is more obvious than that of fibrinolytic system, monitoring the ratio of D - dimer/FDP is helpful to diagnosis of pre - DIC ; after application of low - dose heparin, the ratio of D - dimer/FDP decreases significantly, which contributes to preventing the occurrence of DIC early.
出处
《中国妇幼保健》
CAS
北大核心
2012年第16期2525-2527,共3页
Maternal and Child Health Care of China
关键词
新生儿
弥散性血管内凝血
肝素
Neonate
Disseminated intravascular coagulation
Heparin
