早产儿早期凝血功能与胎龄的关系

Relationship between Early Coagulation Function and Gestational Age in Preterm Infants

目的探讨不同胎龄早产儿早期凝血功能的变化及其临床意义。方法将141例早产儿按不同的胎龄分为早期早产儿组（胎龄27-31＋6周,44例）、中期早产儿组（胎龄32-33＋6周,39例）和晚期早产儿组（胎龄34-36＋6周,58例）。各组出生后2h内抽取静脉血,检测凝血酶原时间（prothrombin time,PT）、活化部分凝血酶原时间（activated partial thromboplastin time,APTT）、凝血酶时间（thrombin time,TT）及纤维蛋白原（fibrinogen,FIB）的水平,并对各检测指标与胎龄的相关性进行分析。结果中期早产儿组、晚期早产儿组PT、APTT、TT均较早期早产儿组短,FIB水平均较早期早产儿组升高（均P〈0.05）。早期早产儿组、中期早产儿组、晚期早产儿组的PT、APTT、TT与胎龄呈负相关（r=-0.67、-0.31、-0.33,均P〈0.05）,早期早产儿组、中期早产儿组、晚期早产儿组的FIB与胎龄呈正相关（r=0.34,P〈0.05）。结论早产儿早期凝血功能与胎龄有密切关联,在早期早产儿组尤为明显。当PT、APTT延长及FIB降低时,应引起足够重视,注意复查凝血功能,必要时进行干预治疗。

Objective To investigate the changes in early coagulation function and its clinical significance in preterm infants of different gestational ages.Methods A total of 141 preterm infants were divided into three groups：early preterm group（gestational age ranged from 27 to 31＋6weeks,44cases）,moderate preterm group（gestational age ranged from 32 to 33＋6 weeks,39cases）,and late preterm group（gestational age ranged from 34 to 36＋6 weeks,58cases）.Venous blood samples were collected within 2hours after birth to detect prothrombin time（PT）,activated partial thromboplastin time（APTT）,thrombin time（TT）and fibrinogen（FIB）levels.The relationships of these indicators to gestational age were analyzed.Results Compared with early preterm group,the PT,APTT and TT were shortened and the FIB levels were increased in both moderate preterm group and late preterm group（P〈0.05）.In addition,PT,APTT and TT were negatively correlated with gestational age but FIB was positively correlated with gestational age in all the three groups（r=-0.67,-0.31,-0.33 and 0.34,respectively;P〈0.05）.ConclusionThe early coagulation function is closely associated with the gestational age in preterm infants,especially in early preterm infants.When PT and APTT are prolonged and FIB is decreased,enough attention should be paid to the coagulation function and the necessary intervention.