The Study Of Platelet Count And Platelet Related Inflammatory Factors' Changes In Pediatric Patients With Pneumonia

Objective:1. To analyze the clinical significance and prognostic value of platelet count in pneumonia in pediatric patients . 2.To investigate the roles of platelets'activation and platelet released inflammatory factor in pneumonia children with wheezing.Methods:1.The study included 102 patients with thrombocytosis in pneumonia (group A)and 107 patients with normal platelet counts in pneumonia(group B).We compared clinical data, laboratory data(Hepatic function, cardiac enzyme, and C-reactive protein),tidal breathing lung function, immunologic function ,the expression of CD62P on platelets and plasma tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6) concentrations between the two groups. 2.We determined the expression of CD62P on platelets and plasma transforming growth factor-βand P-selectin levels among children in pneumonia with wheezing(wheezing group) , without wheezing(no wheezing group) and normal subjects(normal group).We isolated platelet-rich plasma from these children's blood . Then stimulated the platelet-rich plasma with collagen for 30 minutes . Plasma transforming growth factor-β(TGF-β) and P-selectin levels were measured after stimulation.Results:1. Compared with group B, group A had a more severe clinical conditions:presence higher percentage of dyspnea and wheezing and longer hospitalization, white blood count increased ,lung faction parameter including tPTEF,tPTEF/tE,TEF25 and TEF25/PTEF %decreased ,the levels of IgA,IgG in serum declined,the ratio of CD3+leukomonocyte's declined,CD3-CD19+ and CD19+CD23+ leukomonocyte percentage increased, the expression of CD62P on platelets and plasma TNF-αand IL-6 concentrations raised .The difference between the two groups was statistically significant (P<0.05). Patientes in group A were younger than patients in group B, The difference between the two groups was statistically significant (P<0.05).2.The expression of CD62P on platelet in wheezing group was higher than that of normal group, the difference between the two groups was statistically significant (P<0.05). After stimulated the platelet-rich plasma with collagen for 30 minutes , plasma transforming growth factor-β(TGF-β)and P-selectin levels were higher than before stimulation, the difference was statistically significant (P<0.05). The plasma P-selectin concentration of wheezing group after stimulation is higher than that of no wheezing group and normal group,and the difference between them was statistically significant (P<0.05). After stimulation , the plasma TGF-βconcentration of wheezing group after stimulation is higher than that of no wheezing group and normal group, while the plasma TGF-βconcentration of no wheezing group is higher than that of normal group, the difference between them were statistically significant (P<0.05).Conclusions:The severity of pneumonia in chidren is associated with platelet count . Platelet count is a useful clinical marker in judging the severity of pneumonia and guiding therapy, especially in low ages such as infants. The platelet of patients with wheezing had enhanced activity and had much more inflammatory factors . After stimulation,the platelet of patients with wheezing actived and released much more inflammatory factors such as TGF-βand P-selectin and promoted inflammation and induced wheezing .