赵正楼 陈森

【摘要】 目的：探究支原體肺炎患儿凝血酶调节蛋白及凝血指标的变化及与疾病严重程度的关系。方法：选取2017年6月-2019年12月本院100例支原体肺炎患儿为观察组，同时期的100名健康儿童为对照组。比较两组的血浆凝血酶调节蛋白（TM）及凝血指标（D-D、FIB、sP-selectin及TXB2）;比较观察组中不同严重程度（PSI分级）、肺外并发症发生情况及疾病时期的检测结果;采用Spearman秩相关分析血浆TM及凝血指标与PSI分级的关系。结果：观察组的血浆TM及凝血指标均高于对照组（P<0.05）。观察组中PSI分级较高、合并肺外并发症及急性期者的血浆TM及凝血指标均高于PSI分级较低、无肺外并发症及恢复期者，差异均有统计学意义（P<0.05），Spearman秩相关分析显示，血浆TM及D-D、FIB、sP-selectin及TXB2均与PSI分级呈正相关（rs=0.796、0.833、0.912、0.933、0.897;P<0.05）。结论：支原体肺炎患儿凝血酶调节蛋白及凝血指标的表达均升高，且与疾病严重程度密切相关，因此在支原体肺炎患儿中的检测价值较高。

【关键词】 支原体肺炎 凝血酶调节蛋白 凝血指标 疾病严重程度

Investigation on the Change of Thrombomodulin and Coagulation Indexes of Children with Mycoplasmal Pneumonia and the Relationship with Disease Severity/ZHAO Zhenglou， CHEN Sen. //Medical Innovation of China， 2021， 18（13）： 0-051

[Abstract] Objective： To investigate the change of thrombomodulin and coagulation indexes of children with mycoplasmal pneumonia and the relationship with disease severity. Method： A total of 100 children with mycoplasmal pneumonia from June 2017 to December 2019 in our hospital were chosen as the observation group， 100 healthy children at the same time were chosen as the control group. Then the plasma thrombomodulin （TM） and coagulation indexes （D-D， FIB， sP-selectin and TXB2） of two groups were compared; and the detection results of the above indexes in the observation group with different severity （PSI grades）， extrapulmonary complications situation and disease period were compared; then the relationship between plasma TM， coagulation indexes and PSI grades were analyzed with Spearman rank correlation analysis. Result： The plasma TM and coagulation indexes of observation group were higher than those of control group （P<0.05）. The plasma TM and coagulation indexes of observation group with higher PSI grades， extrapulmonary complications and at acute stage were higher than those of patients with lower PSI grades， without extrapulmonary complications and at convalescent stage， there were statistically significant differences （P<0.05）. The Spearman rank correlation analysis showed the plasma TM and D-D， FIB， sP-selectin， TXB2 were positively correlated with PSI grades （rs=0.796， 0.833， 0.912， 0.933， 0.897， P<0.05）. Conclusion： The thrombomodulin and coagulation indexes of children with mycoplasmal pneumonia are higher， and they are closely related to the disease severity， the detection value in the children with mycoplasmal pneumonia are higher.

[Key words] Mycoplasmal pneumonia Thrombomodulin Coagulation indexes Disease severity

First-authors address： Yicheng District Peoples Hospital of Zaozhuang City， Zaozhuang 277300， China

doi：10.3969/j.issn.1674-4985.2021.13.012

支原体肺炎是小儿肺炎中占比较高的一类肺炎，本类患儿的呼吸系统受损明显，除此之外，还可导致患儿出现肺外损伤，而重症肺炎甚至可导致患儿死亡[1-2]。临床中对于支原体肺炎患儿的诊治研究中，关于血液指标的研究多见，且血液标本的采集较为简便，因此研究的重视程度较高。凝血酶调节蛋白及凝血指标作为机体凝血相关的指标，其在肺炎患儿中表达的研究多见，且研究多认为支原体感染可导致上述指标表达的升高，但是上述指标与疾病严重程度关系的研究仍差异较大[3-4]。因此，本研究就支原体肺炎患儿凝血酶调节蛋白及凝血指标的变化及与疾病严重程度的关系进行探究，现报道如下。

1 资料与方法

1.1 一般资料 选取2017年6月-2019年12月100例支原体肺炎患儿为观察组，同时期的100名健康儿童为对照组。对照组纳入标准：（1）年龄<14岁;（2）体检示健康。观察组纳入标准：（1）年龄<14岁的儿童;（2）符合支原体肺炎诊断标准。排除标准：（1）合并慢性基础性疾病;（2）合并其他病原菌感染;（3）合并创伤;（4）合并代谢性疾病;（5）入院前进行抗凝相关治疗;（6）合并凝血功能异常。本研究经医院伦理学委员会审批通过，家长对研究知情同意及积极配合。

1.2 方法 采集两组入院时……