Lauterbach Ryszard, Pawlik Dorota, Radziszewska Renata, Woźniak Joanna, Rytlewski Krzysztof
Department of Neonatology, Jagiellonian University Medical College, Kopernika 23, 31-501 Cracow, Poland.
Eur J Pediatr. 2006 Sep;165(9):585-9. doi: 10.1007/s00431-006-0139-7. Epub 2006 Apr 25.
The aim of this prospective, observational study was to establish the prognostic values of plasma antithrombin III (ATIII) and protein C (PC) functional levels, determined in 150 neonates with suspected late-onset sepsis.
Both the ATIII and PC concentrations were significantly lower in neonates with sepsis, either confirmed or not confirmed by blood culture, than data obtained in infants with excluded disease. The lowest values of plasma ATIII and PC were observed in neonates who had died in the course of sepsis. The differences between survivors and non-survivors were statistically significant (respectively, for ATIII P=0.003 and for PC P=0.00002). A highly statistically significant correlation (P=0.0016) between plasma PC functional level and risk of death was found in patients with sepsis. However, plasma ATIII concentration, evaluated in the same group of patients, did not correlate with the occurrence of death.
We concluded that the measurement of plasma ATIII and, especially, PC levels may facilitate the recognition of sepsis and, with respect to PC, may have a prognostic value. Plasma PC functional concentration below 10% might be the indication for supplementation of PC concentrate.
这项前瞻性观察性研究的目的是确定150例疑似晚发性败血症新生儿血浆抗凝血酶III（ATIII）和蛋白C（PC）功能水平的预后价值。
败血症新生儿（无论血培养是否确诊）的ATIII和PC浓度均显著低于排除疾病的婴儿。在败血症病程中死亡的新生儿血浆ATIII和PC值最低。存活者与非存活者之间的差异具有统计学意义（ATIII的P值为0.003，PC的P值为0.00002）。在败血症患者中发现血浆PC功能水平与死亡风险之间存在高度统计学意义的相关性（P = 0.0016）。然而，在同一组患者中评估的血浆ATIII浓度与死亡的发生无关。
我们得出结论，血浆ATIII尤其是PC水平的测定可能有助于败血症的识别，就PC而言，可能具有预后价值。血浆PC功能浓度低于10%可能是补充PC浓缩物的指征。
