肺炎患儿血小板增高的临床意义

中国儿童保健杂志 ›› 2011, Vol. 19 ›› Issue (12): 1152-1154.

肺炎患儿血小板增高的临床意义

孙激扬¹,季伟²,周卫芳²,陈正荣²

1 江苏省常熟市第五人民医院儿科,江苏常熟 215500;
2 苏州大学附属儿童医院呼吸科,江苏苏州 215006

收稿日期:2011-07-14 发布日期:2011-12-06 出版日期:2011-12-06

The clinical significance of thrombocytosis in pediatric patients with pneumonia

SUN Ji-yang¹,JI Wei²,ZHOU Wei-fang² ,CHEN Zheng-rong²

1 Department of Pediatrics, Changshu No.5 People's Hospital,Changshu,Jiangsu 215500,China;
2 Department of Respiratory,the Children's Hospital Affiliated to Soochow University,Suzhou, Jiangsu 215003,China

Received:2011-07-14 Online:2011-12-06 Published:2011-12-06

摘要/Abstract

摘要： 【目的】通过对肺炎伴血小板增多的儿童进行临床特征、实验室指标及潮气通气肺功能检测分析,探讨血小板计数能否作为评判儿童肺炎严重程度和预后的量化指标。【方法】对102例肺炎伴有血小板增多(外周血血小板计数＞400×10⁹/L)的患儿(A组)与107例肺炎血小板计数正常的患儿(B组)的临床特点、血实验室生化指标、血浆肿瘤坏死因子-α(TNF-α)和白细胞介素(IL-6)、潮气通气肺功能检测数据进行比较。【结果】与B组比较, A组发生呼吸困难和喘息比例高,住院时间长,白细胞计数高,血浆TNF-α、IL-6的表达增高,代表小气道阻塞的肺功能指标呼气达峰时间(tPTEF)、达峰时间比(呼气达峰时间/呼气时间、tPTEF/tE)、剩余25%潮气量时的呼气流速(TEF25)、剩余25%潮气量时的呼气流速/呼气峰流速(TEF25/PTEF%)降低,差异有统计学意义(P<0.05)。外周血小板计数与IL-6浓度成正相关(r=0.354,P<0.05),与tPTEF/tE、 TEF25呈负相关(r=0.461、0.407,P＜0.05)。【结论】外周血血小板计数升高可作为评判肺炎的炎症反应及病情严重程度的实用参考指标。

关键词: 肺炎, 血小板增多, 儿童

Abstract: 【Objective】 To analyze the clinical significance of thrombocytosis in pediatric patients with pneumonia. 【Methods】 209 patients with pneumonia were divided into 2 groups: 102 patients with thrombocytosis (platelet count＞400×10⁹/L, group A), 107 patients with normal platelet counts (group B). Clinical data, laboratory data, plasma tumor necrosis factor-α (TNF-α)and interleukin-6(IL-6) concentrations, tidal breathing lung function were compared. 【Results】 Compared with group B, there were more severe clinical conditions in group A: higher percentage of dyspnea and wheezing and longer hospitalization, higher white blood count, lower lung function parameter including tPTEF、tPTEF/tE、TEF25 and TEF25/PTEF%,higher plasma concentrations of TNF-α and IL-6. The difference between the two groups was statistically significant (P<0.05). There were positive correlation between plasma concentrations of IL-6 and platelet count (r=0.354,P＜0.05). Platelet count was negatively correlated with two kinds of pulmonary function parameters( tPTEF/tE、TEF25)(r= 0.461、0.407,P＜0.05). 【Conclusions】 The severity of pneumonia in children is associated with platelet count. Platelet count is a useful clinical marker in judging the severity of pneumonia and guiding therapy.

Key words: pneumonia, thrombocytosis, child

中图分类号:

R725.6

孙激扬,季伟,周卫芳,陈正荣. 肺炎患儿血小板增高的临床意义[J]. 中国儿童保健杂志, 2011, 19(12): 1152-1154.

SUN Ji-yang,JI Wei,ZHOU Wei-fang ,CHEN Zheng-rong. The clinical significance of thrombocytosis in pediatric patients with pneumonia[J]. journal1, 2011, 19(12): 1152-1154.

参考文献

[1] nsal E,Aksaray S,Kksal D,et al,Potential role of interleukin 6 in reactive thrombocytosis and acute phase response in pulmonary tuberculosis[J].Postgrad Med J,2005,81:604-607.
[2] 胡亚美,江载芳.诸福棠实用儿科学[M]. 7版.北京:人民卫生出社,2002:1174-1185.
[3] Vasiliki V,Gavriela F.Thrombocytosis in pediatric patients is associated with severe lower respiratory tract inflammation[J].Archives of Medical Research,2006,37:755-759.
[4] 张园海,徐强,任跃,等.肺炎继发血小板增多的临床特征分析[J].实用医学杂志,2009,25,(21):3642-3644.
[5] Elzey BD,Sprague DL,Ratliff TL.The emerging role of platelets in adaptive immunity [J].Cell Immunol,2005,238 ( 1 ):1 - 9 .
[6] Dang B,Wiehler S,Patel KD.Increased PSGL-1 expression on granulocytes from allergic-asthmatic subjects results in enhanced leukocyte recruitment under flow conditions[J].J Leukoc BiolL,2002,72(4):702-710.
[7] Parameswaran N, Patial S.Tumor necrosis factor-α signaling in macrophages[J]. Crit Rev Eukaryot Gene Expr,2010,20(2):87-103.
[8] 叶新明,钱克检,重症肺炎支原体肺炎肺泡灌洗液中TNF-α、IL-6、IL-8、IL-10水平观察[J].南昌大学学报:医学版,2010,50(4):72-74.
[9] Brightling C,Berry M,Amrani Y.Targeting TNF-alpha:a novel therapeutic approach for asthma[J].Journal of Allergy & Clinical Immunology,2008,121(1):5-10.
[10] Qiu Z,Fujimura M, Kurashima K,et al.Enhanced airway inflammation and decreased subepithelial fibrosis in interleukin 6-deficient mice following chronic exposure to aerosolized antigen[J].Clinical & Experimental Allergy,2004,34(8):1321-1328.
[11] Dodig S ,Raos M,Kovac K,et al.Thrombopoietin and interleukin-6 in children with pneumonia-associated thrombocytosis[J].Arch Med Res,2005,36 (2):124-128 .
[12] 黄旭强,邓力,何春卉,等,婴幼儿肺炎链球菌肺炎的肺功能检测及临床特征分析[J],实用医学杂志,2009,25(2)244-246.
[13] Ramirez JA,Aliberti S,Mirsaeidi M,et al.Acute myocardial infarction in hospitalized patients with community-acquired pneumonia[J].Clin Infect Dis,2008,47 (2): 182-187.

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