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目的:探讨不同程度全身炎性反应综合征(SIRS)患儿血浆D-二聚体(DD)、组织纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制物1(PAI-1)的表达情况及其与病情危重程度的关系。方法:收治SIRS患儿77例为病例组,采用急性生理和慢性健康状况评估Ⅱ(APACHE-Ⅱ)评分,<8分者为轻型组(SIRS1组),≥8分者为重型组(SIRS2组)。另选同期正常儿童30例为对照组。测定并比较两组DD、t-PA及PAI-1的表达情况。结果:与对照组相比,SIRS1组、SIRS2组急性期DD、t-PA、PAI-1含量明显增高(P<0.05);与SIRS1组相比,SIRS2组急性期DD、PAI-1含量明显增高,t-PA含量明显减低(P<0.05)。结论:(1)SIRS患儿凝血系统被激活,同时伴有纤溶功能亢进。(2)凝血亢进和纤溶系统活化与SIRS病情严重程度有关,与病情较轻患儿相比,病情较重患儿凝血系统被激活的程度较高,且纤溶系统活化在一定程度上受到抑制。
Objective: To investigate the changes of plasma D-dimer (DD), tissue plasminogen activator (t-PA) and plasminogen activator inhibitor 1 (PAI) in children with systemic inflammatory response syndrome (SIRS) -1) expression and its relationship with the severity of the disease. Methods: Totally 77 children with SIRS were enrolled in the study. The acute physiology and chronic health status Ⅱ (APACHE-Ⅱ) scores were evaluated. The patients with SIRS were divided into mild group (SIRS1 group) and severe group (SIRS1≥8) ). Another 30 cases of normal children at the same period as the control group. The levels of DD, t-PA and PAI-1 in the two groups were measured and compared. Results: Compared with the control group, the levels of DD, t-PA and PAI-1 in the SIRS1 and SIRS2 groups were significantly increased (P <0.05). Compared with the SIRS1 group, the levels of DD and PAI-1 in the SIRS2 group were significantly increased Increased, t-PA content was significantly reduced (P <0.05). Conclusion: (1) The coagulation system of children with SIRS is activated, accompanied by hyperfibrinolysis. (2) hyperthyroidism and fibrinolytic system activation and SIRS severity of the disease, compared with children with mild disease, severe conditions in children with higher degree of activation of the coagulation system, and fibrinolytic system activation to some extent by the inhibition.