1型阈值前期和阈值期早产儿视网膜病变血小板参数分析

Platelet parameters analysis in patients with prethreshold type 1 and threshold retinopathy of prematurity

目的观察不同时间段1型阈值前期和阈值期早产儿视网膜病变（retinopathy of prematurity,ROP）患儿血小板相关参数的变化,分析其与ROP发生发展的内在联系。方法收集我院新生儿病房2013年1月至2014年12月诊治的早产儿临床资料,纳入早产儿分为1型阈值前期与阈值期ROP组和对照组,对照组出生孕周与ROP组匹配,眼底筛查未见明显ROP病变,并对两组矫正胎龄为32~33周、36~37周、40~41周、44~45周者的血小板平均体积（mean platelet volume,MPV）和血小板计数（platelet counts,PC）进行比较。结果与对照组相比,ROP组患儿36~37周和40~41周的MPV[（10.86±1.87）f L、（10.12±1.45）f L,（10.74±1.66）f L、（10.17±1.52）f L]显著增加（均为P〈0.05）;32~33周和44~45周MPV[（10.18±1.54）f L、（10.37±1.91）f L,（10.56±1.21）f L、（10.42±0.97）f L]差异均无统计学意义（均为P〉0.05）。与对照组相比,ROP组患儿32~33周、36~37周、40~41周、44~45周的PC[（288.00±143.25）×109L-1、（291.00±113.27）×109L-1,（277.23±92.88）×109L-1、（265.49±102.13）×109L-1,（306.00±171.83）×109L-1、（284.00±143.56）×109L-1,（311.43±131.24）×109L-1、（303.62±94.55）×109L-1]差异均无统计学意义（均为P〉0.05）。进一步进行多因素Logistic回归分析,结果显示MPV与1型阈值前期和阈值期ROP发生相关。结论 MPV的变化可能与ROP的病情严重程度和检查时间的差异相关;MPV增高是1型阈值前期和阈值期ROP发生的高危因素,活化的血小板在1型阈值前期和阈值期ROP的发生发展中发挥重要作用。

Objective To observe the changes of platelet parameters in patients with prethreshold type 1 and threshold retinopathy of prematurity （ROP） on different time period, and investigate the internal relationship between platelet parameters and the occurrence and progress of ROP. Methods In this study, clinical data were retro- spectively reviewed in premature infants of our hospital from January 2013 to December 2014. Enrolled infants were divided into prethreshold type 1 and threshold ROP group and age-matched control group without any ROP. The platelet parameters such as mean platelet volume （MPV） and platelet counts （PC） between two groups on different postconceptional ages （PCA） 32 - 33 weeks, 36 - 37 weeks, 40 - 41 weeks, 44 - 45 weeks were also compared. Results MPV values of the premature infants from ROP group were significantly higher than those in control group at PCA 35 - 37 weeks and 40-41 weeks I （10.86 ±1.87）fL vs （10. 12± 1.45）fL, （10.74 ± 1.65）fL vs （10. 17± 1.52）fL] （all P 〈 0.05 ）. There was no significant difference in MPV values between ROP and control groups at PCA 32 -33 weeks and 44 -45 weeks [ （ 10.18 ±1.54）fL vs （10.37±1.91）fL,（10.55±l.21）fLvs （10.42±0.97）fL] （ all P 〉 0. 05 ） . There was no significant difference in PC values of premature infants from ROP and control groups at different stages of PCA [ （288.00 ±143.25） × 10^9 L^-1vs （291.00 ± 113.27） × 10^9 L^-1 （277.23± 92.88） × 10^9 L^-1vs （265.49±102.13） × 10^9 L^-1,（306.00±171.83） × 10^9 L^-1 vs （284.00±143.56） × 10^9 L^-1,（311.43± 131.24） × 10^9 L^-1vs （303.52 ±94.55 ） × 10^9 L^-1（ all P 〉 0.05 ）. Logistic regression analysis showed that there was a significant rela- tionship between the occurrence of prethreshold type 1 and threshold ROP and high MPV values. Conclusion The changes of MPV values may be associated with severi- ties of ROP and differences of inspection time. The level of MPV is a high risk for the occurrence of prethreshold type 1 and threshold ROP. The activated platelets plays a vi- tal role in the occurrence and progress of prethreshold type 1 and threshold ROP.