极低出生体重儿早发血小板减少症多因素相关分析

Risk factors associated with thrombocytopenia in extremely low birth weight infants

目的探讨极低出生体重儿早发血小板减少症的相关因素。方法选择2011—2013年我院NICU收治的极低出生体重儿进行回顾性研究。根据生后72 h内有无血小板减少症分为早发血小板减少症组和无早发血小板减少症组,对两组患儿临床情况进行比较。结果108例研究对象入选,发生早发血小板减少症45例(41.7%),患儿血小板计数在中位数8天恢复正常。男婴(OR=6.036)、早发感染(OR=8.358)及孕母患妊娠期高血压疾病(OR=5.990)与极低出生体重儿早发血小板减少症相关(P<0.05),胎龄、出生体重、胎膜早破、窒息、产前应用地塞米松、呼吸窘迫综合征等对极低出生体重儿早发血小板减少症无明显影响。结论早发血小板减少症是极低出生体重儿的常见合并症,男婴、早发感染及孕母患妊娠期高血压疾病是极低出生体重儿早发血小板减少症的危险因素。

Objective To investigate factors associated with thrombocytopenia in very low birth weight（ VLBW） infants. Methods This retrospective study collected clinical data of VLBW infants admitted in NICU of the Peking Union Medical College Hospital within 12 hours of birth between Jan.2011 and Dec. 2013,where duration of hospitalization were above 2 weeks. VLBW infants were divided into two groups according to the presence or absence of thrombocytopenia in the first 72 hours after delivery（ early-onset thrombocytopenia）. Their clinical characteristics were compared. VLBW infants with congenital malformation or metabolic disease were excluded from the study. Results A total of 108 subjects were included,and early-onset thrombocytopenia was found in 45（ 41. 7%） infants. The median time for resolving early-onset thrombocytopenia was 10 days. Male gender（ OR = 6. 036）,earlyonset infection（ OR = 8. 358） and hypertensive disease during pregnancy（ OR = 5. 990） were associated with early-onset thrombocytopenia in VLBW infants through Logistic analysis（ P〈0. 05）. Gestational age,birth weight,premature rupture of membrane,asphyxia,prenatal dexamethasone usage,and neonatal respiratory distress syndrome didn ＇t increase the incidence of early-onset thrombocytopenia in VLBW infants（ P〉0. 05）. Conclusions Early-onset thrombocytopenia is a common complication of VLBW infants. Male gender,early-onset infection and hypertensive disease during pregnancy are risk factors associated with early-onset thrombocytopenia in VLBW infants.