Study Of Coagulation Disorders In The Infant Muggy Syndrome

Objective: To investigate the coagulation disorders and the incidence of disseminated intravascular coagulation(DIC) in the children with infant muggy syndrome,and provide valuable evidences for early clinincal intervention and treatment.Methods: The infant muggy syndrome children who entered PICU in our hospital were randomly scored by the pediatric critical illness scoring(PCIS) on the admission day from the november of 2006 to march of 2008.They were divided into three groups according to different scores, the full score is 100.The scores ~100,~80,~70 reprent non-serious(31 cases),serious(27 cases),and extremly serious groups(19 cases) respectively.And we choose 25 cases of surgical patients in elective surgery as a control group in the same period.The activity of AT-Ⅲ:A was measured by chromogenic substrate method after first PCIS;The quantity of D-dimer and P-selection were measured by enzyme linked immumsorbent assay.Results:23 cases(29.87%) complicated DIC in total 77 cases of the infant muggy syndrome children in the three groups,7 cases died with a mortality of 30.44%,which was very higher than that(11.11%) of infant muggy syndrome children without DIC(χ2=4.292, P<0.05 ).The DIC incidence raised as an incrase in PCIS on the admission day (χ2=22.97,P<0.01).The incidence of DIC in serious and extremly serious groups showed significantly higher than that in non-serious group (χ2=6.785, 16.203, P<0.05).The levels of PT,APTT,TT,D-dimer and P-selectin were significantly higher (P<0.05), while the number of PLT and the activity of AT-Ⅲ:A were lowe(rP<0.05) in the infant muggy syndrome compared with the control group, serious and extremly serious groups compared with non-serious group, DIC group compared with non- DIC group ; The levels of DFbg,D-dimer and the activity of AT-Ⅲ:A had a significant difference (P <0.05) in serious group compared with extremly serious group; In addition, the activity of AT-Ⅲ:A was lower ,but the quantity of D-dimer and P-selection were higher in DIC group,their sensitivities were significantly higher (over 90%) than that of PLT(60.87%),APTT (73.91%),TT (52.94%) and DFbg(23.50%) tests(χ2=41.49,P<0.01). Conclusions: The pediatric critical illness score showes the condition of critically ill and the occurrence of DIC in the children with infant muggy syndrome, the coagulation disorders were more obvious and the incidence of DIC increased with the lower score;The use of a number of higher sensitive and specific indicators such as D-D, AT-Ⅲ: A and P-selectin in this study helps the early monitoring and treatment for infant muggy syndrome with coagulation disorders.