The Varieties And Analysis Of Coagulation Indicators In Infants With Severe Pneumonia

ObjectiveBy detecting the relevant indicators that can reflect the coagulation function of infants with severe pneumonia,to summarize the varieties and characteristics of coagulation parameters in children with severe pneumonia and to assess the coagulation status of children with severe pneumonia.Simultaneously,to study the relativity between each coagulation parameter and pediatric critical illness score(PCIS)in assessing the severity of severe pneumonia in infants.Expect to provide theoretical basis for early distinguishing the critical patients,then give them timely intervention.MethodsChildren with pneumonia who were hospitalized in the pediatric ward of the Affiliated Hospital of Yan’an University from October 2015 to October 2016 were selected randomly and were divided into two groups according to the patient’s condition:common pneumonia group(30 cases)and severe pneumonia group(30 cases).At the same time,30 healthy children were selected as normal controls.The levels of relevant indicators(including PT,APTT,FIB,FDP,D-D)and platelet parameters(including PLT,MPV)were measured and compared among groups.Patients with severe pneumonia were divided into three groups according to their PCIS scores:very critical group(≤70 points),critical group(71 to 80 points)and non-critical group(>80 points).The variation of coagulation indicators and the incidence of DIC among groups were measured and compared.To analyze the correlation between coagulation indicators and PCIS.1.There was no significant difference among the group of severepneumonia,common pneumonia and normal control group in terms of age,sex andweight(P> 0.05).2.The levels of coagulation indicators were compared between the pneumoniagroups and the control group.In addition to MPV,the levels of other indicators changedsignificantly among severe pneumonia group,common pneumonia group and controlgroup,the comparisons had significant difference(P <0.05).The levels of APTT,FIB andD-D in the common pneumonia group were significantly higher than those in the controlgroup,there were significant difference between the two groups(P <0.017).The levels ofother indicators in common pneumonia group changed not obviously compared with thecontrol group,there were no significant difference between the two groups(P>0.017).3.The abnormal percentage of coagulation indicators were compared between thecommon pneumonia group and the severe pneumonia group.Except MPV,the abnormalpercentage of coagulation indicators between severe pneumonia group and commonpneumonia group was disparity,with statistical significance(P<0.05).4.The levels of coagulation indicators were compared among extremely criticalgroups,critical group and non-critical group.The level of PLT decreased obviously inextremely critical group compared with critical group and non-critical group,and thecomparison has significant difference(P<0.05).The comparisons of PLT and APTTbetween the critical group and the non-critical group had no significant diffrence(P>0.017).The comparisons of PT,FIB and DD between the critical group and the extremelycritical group had no significant diffrence(P>0.017).The changes of the level of MPVwere not obvious among there groups,the comparisons had no significant difference(P>0.05).There was significant difference(P <0.01),PCIS score of the very critical grpupwas significantly lower than the other two groups.The incidence of DIC in the threegroups was statistically significant(P <0.017),and it was seen that the probability ofoccurrence of DIC increased with the severity of severe pneumonia.5.The analysis of the relativity between coagulation indicators and PCIS showed Results that there was a mildly positive correlation between the PLT and PCIS,r = 0.365,P<0.05.FIB,FDP and DD had moderately negative correlation with PCIS,r were-0.585,-0.435 and-0.46 respectively,P <0.05.Conclusion1.The levels of PLT,PT,APTT,FIB,FDP and D-D in the infants with severe pneumonia were abnormally changed,and the direction of changes were not exactly the same,which indicating that there were different degrees of coagulation dysfunction in infants with severe pneumonia.2.The lower the PCIS score in children with severe pneumonia,the greater the probability of concurrent DIC.The levels of PLT,FIB,FDP and D-D were correlated with PCIS,indicating that the degree of coagulation disorders is associated with the severity of the severe pneumonia.3.The laboratory indicators such as PLT,FIB,FDP and D-D combined with PCIS score can be more effective in judging the coagulation status and severity of patients with severe pneumonia.So that early identification of children with critical degree of early intervention.Expect early identification of children with critical degree,early intervention.Expect to distinguish the critical infants and give them intervention early.