早产儿视网膜病变与血小板参数的相关性研究

Study of platelet indices in preterm infants with retinopathy of prematurity

目的分析早产儿视网膜病变与血小板参数的相关性。方法选择我院新生儿重症监护病房收治的出生胎龄≤32周的早产儿175例,依据眼底镜筛查结果分为早产儿视网膜病变(ROP)组和无早产儿视网膜病变(非ROP)组,其中ROP组66例,胎龄28.5(27.43~29.75)周,出生体质量1100(917.5~1362.5)g,轻度患儿34例,重度患儿32例;非ROP组109例,胎龄30.71(29.14~31.43)周,出生体质量1480(1195~1700)g。回顾性分析两组早产儿母亲妊娠期情况、生后2个阶段血小板参数、早产儿基本资料、并发症及治疗措施等指标。结果单因素回归分析显示出生胎龄、辅助生殖技术、新生儿窒息、出生体质量、呼吸暂停、咖啡因、支气管肺发育不良(BPD)、糖皮质激素、败血症、2个阶段血小板计数、血小板分布宽度和血小板质量指数、总用氧时间、酸中毒、红细胞和血小板输注与ROP相关(P<0.05);而母亲年龄、不良孕产史、分娩方式、胎盘早剥/植入、胎膜早破、羊水、宫内窘迫、妊娠糖尿病、妊娠期高血压、子痫前期/子痫、使用激素促胎肺成熟、双胎/多胎、两个阶段的血小板平均体积与ROP无明显相关性(P>0.05)。多因素分析结果显示酸中毒、出生胎龄、生后1周血小板分布宽度和生后1周血小板质量指数与ROP相关(P<0.05)。结论酸中毒、生后1周血小板分布宽度较大,生后1周血小板质量指数较小,出生胎龄小是ROP发生的独立危险因素。

Objective To determine the relationship between the retinopathy of prematurity(ROP)in preterm infants and platelet parameters.Methods A total of 175 preterm infants[gestational age(GA)≤32 weeks]in the neonatal intensive care unit of our hospital were included,they were divided into ROP group and non-ROP group,according to the results of ophthalmoscope screening,66 preterm infants in the ROP group with the GA was[28.5(27.43-29.75)weeks,the birth weight(BW)was 1100(917.5-1362.5)]g,among them 34 children with mild ROP,32 children with severe ROP;109 preterm infants in non-ROP group,the GA was[30.71(29.14-31.43)]weeks,the BW was[1480(1195-1700)]g.The indexes about maternal pregnancy data,platelet parameters at two postnatal stages,basic informations of preterm infants,complications and therapeutic management were analyzed retrospectively.Results Univariate regression analysis showed that the GA,assisted reproductive technique,neonatal asphyxia,BW,apnea,caffeine use,bronchopulmonary dysplasia(BPD),glucocorticoid use,sepsis,platelet count(PLT)with platelet distribution width(PDW)and platelet mass index(PMI)at two stages,total oxygen time,acidosis,red blood cell transfusions and platelet transfusions were correlated with ROP(P<0.05).And there were no significant relationship with ROP in maternal age,adverse gestational history,delivery mode,placental abruption/implantation,premature rupture of membranes,cloudy amniotic fluid,intrauterine distress,gestational diabetes mellitus,hypertension during pregnancy,preeclampsia/eclampsia,use of glucocorticoid to promote fetal lung maturation,double/multiple births,mean platelet volume(MPV)at two stages(P>0.05).The results of multivariate regression analysis showed that acidosis,GA,PDW and PMI at one week after birth were correlative with ROP(P<0.05).Conclusion Acidosis,a largerer PDW at one week after birth and a smaller PMI at one week after birth,lower GA are independent risk factors for ROP.