NRDS早产儿凝血功能与脑室周围-脑室内出血的关系研究

Relationship between coagulation function and periventricular-intraventricular hemorrhage in premature infants with neonatal respiratory distress syndrome

目的:研究新生儿呼吸窘迫综合征(NRDS)早产儿凝血功能与脑室周围-脑室内出血(PVH-IVH)的关系。方法:根据头颅彩超检测结果,将并发PVH-IVH的NRDS早产儿分为轻度PVH-IVH组42例和重度PVH-IVH组13例,并以同期未发生PVH-IVH的NRDS早产儿40例作为对照组,分析比较3组早产儿生后48h内血浆中凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fbg)、D-二聚体(D-D)及血小板计数(PLT)的变化。结果:轻、重度PVH-IVH组较对照组PT、APTT、TT、D-D升高(P<0.05),Fbg、PLT均下降(P<0.05),且与出血程度呈正相关(P<0.05)。结论:NRDS早产儿凝血功能变化与PVH-IVH密切相关,凝血功能的异常可能参与了NRDS早产儿PVH-IVH的发病机制。

Objective： To study the relationship between coagulation function and periventricular - intraventricular hemorrhage （PVH- IVH） in premature infants with neonatal respiratory distress syndrome （NRDS） . Methods： The premature infants with NRDS combined with PVH -IVH were divided into mild PVH- IVH group （42 cases） and severe PVH- IVH group （13 cases） according to the results of cranial ultrasonography, then 40 premature infants with NRDS and without PVH - IVH were selected as control group, The changes of prothromhin time （ PT）, activated partial thromboplastin time （ AFIT）, thrombin time （ TI＇）, fibrinogen （ Fbg）, D - dimer i D - D ） , platelet （PLT） account in serum were compared among the three groups within 48 hours after birth. Results： Compared to control group, the levels of PT, APTI＇, T＇l＂ and D - D in mild PVH - IVH group and severe PVH - IVH group increased significantly （ P 〈 0.05 ） , Fbg and PLT decreased significantly （ P 〈 0. 05 ）, and were correlated with the severity of PVH -＂ IVH positively （ P 〈 0. 05 ） . Conclusion ： The changes of coagulation function are closely related to PVH - IVH in premature infants with NRDS, and the dysfunction of blood coagulation may participate in the pathogenesis of PVH - IVH.