Procoagulant activity in children with community acquired pneumonia, pleural effusion and empyema
Procoagulant activity in children with community acquired pneumonia, pleural effusion and empyema
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DOI：
10.1002/ppul.20795
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发表时间：
2008-05-01
影响因子：
3.1
通讯作者：
Barbato, A.
中科院分区：
文献类型：
--
作者：
Michelin, E.;Snijders, D.;Barbato, A.
在社区获得性肺炎（CAP）患者中，细菌细胞壁来源的片段可诱导凝血级联反应。为了了解潜在的机制，我们研究了CAP和肺旁积液患儿的纤溶活性。患者与方法：选取20例既往健康的CAP患儿作为研究对象；有（n = 11）或没有（n = 9）胸腔积液（PPE）。我们还调查了10名有脓胸的儿童。在所有儿童中，我们分析了凝血和纤溶参数，并将结果与9个对照组进行了比较。结果：三组患者凝血酶原时间（PT）和部分凝血活酶活化时间（aPTT）与对照组相比均无显著差异（P=0.975， P= 0.535）。纤维蛋白原水平较对照组显著升高（P < 0.0001）。d -二聚体的中位数与对照组（48 μ g/L）相比，肺炎患儿为244 μ g/L，肺炎合并PPE患儿为751 μ g/L，脓胸患儿为2003 μ g/L (P< 0.0001)，有统计学意义。结论：血浆d -二聚体水平可作为评价儿童CAP及其并发症严重程度的附加指标。
In patients with community-acquired pneumonia (CAP), bacterial-cell-wall-derived fragments may induce the coagulation cascade. To contribute to the knowledge of underlying mechanisms, we have studied the fibrinolytic activity in children with CAP and parapneumonic effusions. Patients and Methods: Twenty previously healthy children admitted to our Department with CAP were studied; with (n = 11) or without (n = 9) pleural effusion (PPE). We also investigated 10 children with empyema. In all children we analyzed coagulation and fibrinolytic parameters and compared the results to nine controls. Results: Prothrombin time (PT) and activated partial thromboplastin time (aPTT) were not significantly modified in the three groups as compared to controls (P=0.975, P= 0.535, respectively). The fibrinogen levels were significantly increased in respect to the control group (P < 0.0001). The median values of D-dimer showed an increasing trend that was statistically significant: children with pneumonia 244 mu g/L, with pneumonia and PPE 751 mu g/L and with empyema 2003 mu/L, in respect to values (48 mu g/L) of our control group (P< 0.0001). Conclusion: The results suggest that plasma level of D-dimer can give an additional contribution for the evaluation of the severity of CAP and its complications in children.