凝血和血小板功能分析仪在检测川崎病患儿不同时期凝血功能中的应用

doi:10.3969/j.issn.1671-2587.2023.05.005

临床输血与检验 ›› 2023, Vol. 25 ›› Issue (5): 607-612.DOI: 10.3969/j.issn.1671-2587.2023.05.005

凝血和血小板功能分析仪在检测川崎病患儿不同时期凝血功能中的应用

王笑欢, 郭凯, 刘倩, 牛子健, 王孟键, 郭婧, 马曙轩

国家儿童医学中心首都医科大学附属北京儿童医院 100045

收稿日期:2023-05-19 出版日期:2023-10-20 发布日期:2023-11-20
通讯作者: 马曙轩,主要从事儿科输血和输血免疫学研究,（E-mail）masxfwyy@sina.com。
作者简介:王笑欢,主要从事儿科凝血机制方面的研究,（E-mail）huanxiao1217@163.com。

Century Clot: Clinical Application of Coagulation Function in Children with Kawasaki Disease

WANG Xiaohuan, GUO Kai, LIU Qian, et al

Department of Transfusion Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045

Received:2023-05-19 Online:2023-10-20 Published:2023-11-20

摘要/Abstract

摘要： 目的用凝血和血小板功能分析仪（century clot）[ 激活凝血时间（activated clotting time,ACT）、血小板功能指数（platelet function,PF）、凝血速率（clot rate,CR）]和常规凝血实验（conventional coagulation test,CCT）评估川崎病（kawasaki disease,KD）患儿不同时期凝血功能,并探讨两种检测方法的一致性。方法选取我院2022年7月—10月收治的38例KD患儿样本,分析患儿的century clot、CCT和血小板计数（PLT）结果,评价患儿凝血状态。同时,通过Kappa一致性分析比较两种方法的一致性。结果 KD患儿的ACT（s）亚急性期（148.50±37.18 ）与急性期（184.23±39.2）相比明显缩短,PLT（×10⁹/L）亚急性期（491.50±126.91）与急性期（374.35±105.70）相比明显增高,（P均<0.05）,其余检测指标两期无明显差异;PF值,与对照组（3.54±0.89）相比,急性期（4.34±0.8）和亚急性期（4.21±0.92）均明显增强（P<0.05）。CR值（凝结信号/min）,与对照组（21.59±4.45）相比,急性期（45.03±15.99）和亚急性期（48.19±7.79）均明显增强（P<0.05）。与对照组相比,急性期和亚急性期的纤维蛋白原和D-二聚体均明显增强（P<0.05）。其他指标无明显差异。Century clot与CCT检测KD患儿凝血功能的Kappa一致性分析显示均较差。结论 KD患儿主要表现为血小板及纤维蛋白原功能及含量升高、纤维蛋白裂解产物增多的高凝状态;亚急性期比急性期血小板含量增多,凝血因子功能增强。Century clot与CCT检测KD患儿凝血功能一致性差,两者互相不可替代,可结合两种方法以提高KD患儿诊断和治疗的准确性。

关键词: 川崎病, 凝血功能, 凝血和血小板功能分析仪, 常规凝血实验

Abstract: Objective The coagulation function of children with Kawasaki disease (KD) was tested by Century Clot (Activated Clotting Time (ACT), Platelet Function (PF), Clot Rate (CR))parameters and conventional coagulation testing (CCT). The consistency of the two detection methods were analyzed. Methods A total of 38 KD children admitted to our hospital from July 2022 to October 2022 were selected to test Century Clot, CCT and platelet count (PLT) to evaluate the coagulation function. The consistency of the two methods was compared by Kappa analysis. Results ACT (s) in subacute stage (148.50±37.18) was significantly shorter than that in acute stage (184.23±39.2), and PLT (×10⁹/L) in subacute stage (491.50±126.91) was significantly higher than that in acute stage (374.35±105.70) (both P<0.05). There was no significant difference between the two stages in other test indicators. PF values in acute stage (4.34±0.8) and subacute stage (4.21±0.92) were significantly increased compared with control group (3.54±0.89) (P<0.05). The value of CR (Condensation signal/min) in acute stage (45.03±15.99) and subacute stage (48.19±7.79) was significantly increased compared with control group (21.59±4.45) (P<0.05). Fibrinogen and D-dimer in acute and subacute stages were significantly increased (P<0.05). There was no significant difference in other indicators. The Kappa consistency analysis of Century clot and CCT showed poor coagulation function. Conclusion KD Children mainly showed hypercoagulability with increased platelet count and Fibrinogen function and content, and Fibrin cleavage products. The platelet content in subacute stage was higher than that in acute stage, and the function of coagulation factor was enhanced. The consistency of Century clot and CCT in detecting coagulation function in KD children was poor, and the two methods are irreplaceable. Combining the two methods can improve diagnosis and treatment of KD children

Key words: Kawasaki disease, Coagulation function, Century clot, Coagulation test

中图分类号:

R457

王笑欢, 郭凯, 刘倩, 牛子健, 王孟键, 郭婧, 马曙轩. 凝血和血小板功能分析仪在检测川崎病患儿不同时期凝血功能中的应用[J]. 临床输血与检验, 2023, 25(5): 607-612.

WANG Xiaohuan, GUO Kai, LIU Qian, et al. Century Clot: Clinical Application of Coagulation Function in Children with Kawasaki Disease[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2023, 25(5): 607-612.

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凝血和血小板功能分析仪在检测川崎病患儿不同时期凝血功能中的应用

Century Clot: Clinical Application of Coagulation Function in Children with Kawasaki Disease

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