不同出生体重新生儿第1天血小板及凝血功能的分析

Analysis of platelet and blood coagulation function on the first day of birth in neonates with different birth weight

目的研究不同出生体重新生儿出生第1天的血小板(PLT)及凝血功能及其临床意义。方法选择2017年1～10月我院收治的200例新生儿,依据出生体重分为极低出生体重儿组(32例)、低出生体重儿组(58例)、正常出生体重儿组(69例)、巨大儿组(41例)。另取50例同期正常足月儿作为对照组。各组均于生后第1天内进行血小板和凝血功能检查,比较各组新生儿的PLT及凝血功能。结果各组间的PLT、凝血酶原时间(PT)、凝血酶原时间活动度(PTA)、国际正常化比值(INR)、部分活化凝血酶时间水平比较,差异有统计学意义(P<0.05)。各组间的凝血酶时间(TT)、纤维蛋白原(FIB)水平比较,差异无统计学意义(P>0.05)。极低出生体重儿组的PLT水平低于低出生体重儿组、正常出生体重儿组、巨大儿组和对照组,差异有统计学意义(P<0.05)。极低出生体重儿组的PT、INR、APTT水平高于低出生体重儿组、正常出生体重儿组、巨大儿组和对照组,差异有统计学意义(P<0.05)。结论出生第1天PLT及凝血功能的异常可作为极低出生体重儿脑室内出血风险增高的指征之一。

Objective To study the clinical significance of the platelet (PLT) and blood coagulation function on the first day of birth in neonates with different birth weight. Methods A total of 200 newborns born in our hospital from January to October in 2017 were selected as study object,then they were divided into the very low birth weight infant group (32 infants),the low birth weight group (58 infants),the normal birth weight infant group (69 infants),and the macrosomia infant group (41 infants). Altogether 50 full-term neonates during the same period were selected as the control group. The platelet and blood coagulation function were examined in each group within the first day after birth,and the PLT and blood coagulation function of the newborns in each group were compared. Results There was statistically significant difference in the level of PLT,prothrombin time (PT),prothrombin time activity (PTA),international normalized ratio (INR) and activated partial thromboplastin time (APTT) among each groups (P<0.05). There was no significant difference in thrombin time (TT) and fibrinogen (FIB) levels among groups (P>0.05). The PLT level of the very low birth weight infant group was lower than that of the low birth weight infant group,the normal birth weight infant group,the macrosomia infant group and the control group,the difference was statistically significant (P<0.05). The levels of PT,INR and APTT in the very low birth weight infant group were higher than those in the low birth weight infant group,the normal birth weight infant group,the macrosomia infant group and the control group,the difference was statistically significant (P<0.05). Conclusion Abnormal in PLT and coagulation function on the first day of birth may be one of the indicators of increased risk of intraventricular hemorrhage in very low birth weight infants.