全身炎症反应综合征患儿C-反应蛋白、D-二聚体和血小板计数的临床价值

目的研究CRP、D-二聚体和血小板在小儿SIR向MODS转化中的临床意义。方法儿科病例130例，其中SIRS组95例，非SIRS组35例，SIRS组分为MODS组与非MODS组，分别测定CRP，D-二聚体和血小板。结果①人院后24h内SIRS组CRP、D-二聚体明显高于非SIRS组（P〈0．01）；而血小板则明显降低（P〈0．01）。⑦入院后24hMODS组CRP、D-二聚体明显高于非MODS组（P〈0．05）；而血小板则低于非MODS组（P〈0．05）。③1周后SIRS组CRP仍高于非SIRS组（P〈0．05），但其D-二聚体和血小板与非SIRS组比较，差别均无显著性意义（P〉0．05）。④1周后MODS组CRP仍高于非MODS组（P〈0．05）、但两组D-二聚体和血小板则无显著差异（P〉0．05）。⑤6例死亡患儿CRP、D-二聚体和血小板在入院后第3、第5和第7天均无明显变化。结论IRS患儿CRP、D-二聚体明显升高，血小板降低，合并MODS时上述变化进一步加剧，随着病情改善可恢复正常。CRP、D-二聚体升高和血小板降低是SIRS患儿病情危重的早期信号。

Clinical value of C-reactive protein, D-dimer and platelet count in chil- dren with systemic inflammatory response syndrome

Objective To explore the values of CRP, D-dimer and platelet in children with SIRS in transformation to MODS. Methods A total of 130 cases were researched, 95 cases in SIRS group and 35 cases in non SIRS group, SIRS group were divided into MODS group and non MODS group. CRP, D-dimer and platelet were determined respectively. Results （~）CRP and D-dimer in SIRS group were significantly higher than those of non SIRS group （P 〈 0.01 ） with- in 24 h after admission; While the platelet in SIRS group was significantly lower than that of non SIRS group （P 〈 0.01 ）. （~）CRP and D-dimer in MODS group were significantly higher than those of non MODS group 24 hours late （P 〈 0.05）; While, the platelet in MODS group was lower than that of non MODS group （P 〈 0.01）. （~）CRP in SIRS group was higher than that of non SIRS group a week late （P 〈 0.01 ）; D-dimer and platelet in SIRS group were different with those of non SIRS group, but the difference were not significant （P 〉 0.05）. （~）CRP in MODS group was higher than that of non MODS group （P 〈 0.05）, but D-dimer and platelet had no difference between the two groups a week late （P 〉 0.05）o （~） CRP, D-dimer and platelet count showed no significant changes in the 6 dead cases in third, fifth and seventh day after admission. Conclusion CRP, D-dimer increased significantly but platelet decreased in SIRS children, these changes further intensified if SIRS complicated MODS, but these changes could recover with the disease Improved. CRP and D-dimer reduction, and platelet elevation were the early critical signals in SIRS.