不同胎龄肺出血新生儿的凝血功能指标特征

Characteristics of coagulation function in neonates of different gestational ages with pulmonary hemorrhage

目的分析不同胎龄肺出血新生儿凝血功能指标特征。方法选取2016年1月～2018年3月在我院NICU住院的肺出血新生儿90例患儿,按照胎龄的不同均分为3组,每组各30例。早产儿1组:出生时胎龄<34周的早产儿;早产儿2组:出生时胎龄34～36^(+6)周出生的近足月儿;足月新生儿组:出生时胎龄37～42周。收集不同胎龄肺出血新生儿活化部分凝血酶原时间(prothrombin time,PT)、凝血酶原时间(thromboplasti,APTT)、D-二聚体(DD)、纤维蛋白原(fibrinogen,FIB)的指标,比较不同胎龄的肺出血新生儿凝血指标的差异。结果早产儿1组的APPT、D-D的水平均明显高于早产儿2组,APTT、PT长于早产儿2组(P<0.05),FIB水平明显低于早产儿2组(P<0.05)。早产儿1组的APTT、D-D的水平明显高于足月新生儿组,APTT、PT大于足月新生儿组(P<0.05),FIB水平明显低于足月新生儿组(P<0.05)。足月新生儿组和早产儿2组比较,APTT、PT、FIB差异无统计学意义(P>0.05),但早产儿2组的D-D、纤维蛋白降解产物(FDP)明显高于足月新生儿组(P<0.05)。新生儿胎龄越大,PT、APTT越短,D-D的水平越低。结论胎龄越小的新生儿极易出现凝血功能紊乱,同时随新生儿胎龄的变化,D-D的水平变换显著,可作为分析新生儿功能紊乱的指标之一。比较分析PT、APTT及FIB、FDP水平,能及时发现新生儿的凝血功能异常,便于及时治疗,能有效提高早产儿的生存率。

Objective To analyze the characteristics of coagulation function in neonates of different gestational ages with pulmonary hemorrhage.Methods Altogether 90 cases of neonates with pulmonary hemorrhage treated in NICU of our hospital from January 2016 to March 2018 were selected as research targets,and were divided into 3 groups according to gestational age,30 cases in each group.Preterm neonates in group 1:preterm neonates with gestational age of fewer than 34 weeks at birth;preterm neonates in group 2:neonates with gestational ages ranging from 34 weeks to 36+6 weeks of full-term at birth;full-term neonates in group 3:neonates with gestational ages of 37 weeks to 42 weeks.The indexes of fibrinogen,activated partial thromboplastin time(prothrombin time,PT),prothrombin time(thromboplasti,APTT),D-dipolymer(D-D)and fibrinogen(fibrinogen,FIB)were collected to make a comparison of the difference in blood coagulation index among neonates of different gestational ages.Results The levels of and D-D of the neonates in group 1 were significantly higher than those in group 2,APPT and PT were longer than those in group 2(P<0.05),and the level of FIB was significantly lower than that in group 2(P<0.05).Compared with those of group 3,the levels of and D-D in group 1 were significantly higher than those in group 3 APTT,PT were congertnan those in groups(P<0.05),and the level of FIB was significantly lower than that in group 3(P<0.05).There were no statistically significant differences in the APTT,PT and FB indexes between the preterm neonates in group 2 and the full-term neonates in group 3(P>0.05),but the D-D and fibrin degradation product(FDP)indexes of the preterm neonates in group 2 were obviously higher than those of the full-term neonates in group 3(P<0.05).The older the neonates′gestational age was,the lower the APTT and D-D levels would be,and the shorter the APPT,PT would be.Conclusion The neonates with younger gestational age are likely to have coagulation disorders,and with the change of fetal age,the change in the D-D level is significant,which can be used as one of the indicators for the analysis of neonatal dysfunction.The comparative analysis APTT,PT and the levels of FIB and FDP can help to find the abnormal coagulation function of the neonates in time,which will attribute to timely treatment of the disease.Thus the survival probability of preterm neonates can be enhanced.