摘要
目的 凝血异常是未矫正先天性心脏病患儿的严重并发症和死亡原因,本研究旨在筛查先天性心脏病患儿凝血异常的患病率和相关因素,并比较紫绀型和非紫绀型患儿的凝血异常情况.方法 纳入年龄在0～3岁于2016年1月至2019年12月在中国医学科学院阜外医院就医的未矫正先天性心脏病患儿650例,包括245例紫绀型先天性心脏病和405例非紫绀型先天性心脏病.统计紫绀型与非紫绀型先天性心脏病患儿全血细胞计数和凝血常规检测结果,使用血小板计数、凝血酶原时间、活化部分凝血活酶时间、D-二聚体、纤维蛋白原和纤维蛋白降解产物测定值判断是否发生凝血异常.结果 紫绀型和非紫绀型先天性心脏病患儿凝血异常发生率分别是60.4％和44.7％.红细胞数、血红蛋白浓度、红细胞比容、红细胞体积分布宽度与血小板计数、凝血酶原时间、活化部分凝血酶原时间相关性具有统计学意义(P<0.05).结论 未经矫正的先心病患儿凝血异常是常见的,相较于非紫绀型先天性心脏病患儿,紫绀型先天性心脏病患儿凝血异常更易发生.
Abstract
Objective Coagulation abnormalities are a serious complication and the cause of death in children with uncorrected congenital heart disease.The aim of this study is to evaluate the prevalence and identify related factors of coagulation abnormalities in children with congenital heart disease,and to further compare the coagulation abnormalities between cyanotic and non-cyanotic groups of children.Methods A total of 650 children with uncorrected congenital heart disease,including 245 cases of cyanotic congenital heart disease and 405 cases of non-cyanotic congenital heart disease,who were treated at Fuwai Hospital of the Chinese Academy of Medical Sciences from January,2016 to December,2019,were included for the study.We collected the whole blood cell count and coagulation routine test results of children with cyanotic and non-cyanotic congenital heart disease,and used platelet count,prothrombin time, activated partial thromboplastin time,D-dimer,fibrinogen,and fibrinogen degradation product test values to determine whether coagulation abnormalities had occurred.Results The incidence of coagulation abnormalities in children with cyanotic and non-cyanotic congenital heart disease were 60.4％ and 44.7％,respectively.The correlations between the number of red blood cells,hemoglobin concentration,hematocrit,and distribution width of red blood cell volume with platelet count, prothrombin time,and activated partial prothrombin time were statistically significant (P<0.05). Conclusion Uncorrected coagulation abnormalities are common in children with congenital heart disease.When compared with children with non-cyanotic congenital heart disease,children with cyanotic congenital heart disease are more prone to have coagulation abnormalities.
维普
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