红细胞体积分布宽度及平均血小板体积与早产儿脑室内出血预后的关系

Relationship of red cell volume distribution width and mean platelet volume with poor prognosis of intraventricular hemorrhage in premature infants

目的探讨红细胞体积分布宽度(RDW)和平均血小板体积(MPV)与早产儿脑室内出血预后的相关性。方法选取2018年6月至2022年6月嘉兴市妇幼保健院新生儿ICU收治的早产儿185例为研究对象。所有患儿均在入院后测定RDW、MPV水平,根据有无脑室内出血分为脑室内出血组和无出血组,并根据脑室内出血预后情况分为预后良好组及预后不良组,分析不同组间RDW、MPV水平的差异,采用Pearson相关分析脑室内出血患儿RDW、MPV水平与格拉斯哥预后评分(GOS)的相关性,采用ROC曲线评估RDW、MPV单独及联合预测早产儿脑室内出血不良预后的效能。结果185例早产儿中,经检查确诊脑室内出血80例(43.24%),无脑室内出血105例(56.76%)。脑室内出血组患儿RDW、MPV水平均高于无出血组,差异均有统计学意义(均P<0.05)。80例脑室内出血组早产儿中,预后良好66例(82.50%),预后不良14例(17.50%)。预后不良组患儿RDW、MPV水平均高于预后良好组,差异均有统计学意义(均P<0.05)。Pearson相关分析显示,脑室内出血患儿RDW、MPV水平与GOS评分均呈正相关(r=0.589、0.602,均P<0.05)。ROC曲线分析显示,RDW联合MPV预测早产儿脑室内出血不良预后的AUC为0.502,灵敏度为0.963,特异度为0.901。结论RDW、MPV与早产儿脑室内出血患儿预后相关,早期监测有助于评估及改善预后。

Objective To explore the relationship of red cell volume distribution width(RDW)and mean platelet volume(MPV)with poor prognosis of intraventricular hemorrhage in premature infants.Methods Clinical data of 185 premature infants admitted to the neonatal intensive care unit(NICU)of Jiaxing Maternity and Child Health Care Hospital from June 2018 to June 2022 were retrospectively analyzed.There were 80 cases(43.24%)diagnosed with intraventricular hemorrhage(study group),and 105 cases(56.76%)without intraventricular hemorrhage(control group).In the study group,66 cases(82.50%)showed a good prognosis(good prognosis subgroup)and 14 cases(17.50%)had a poor prognosis(poor prognosis subgroup).RDW and MPV levels were measured after admission in all infants and compared between groups.The correlation of RDW and MPV levels with the prognosis of intraventricular hemorrhage was analyzed by Pearson analysis,their predictive value for predicting the prognosis was analyzed by the receiver operating characteristic curve(ROC).Results The levels of RDW and MPV in the study group were significantly higher than those in the control group(both P<0.05).The levels of RDW and MPV in the poor prognosis subgroup were significantly higher than those in the good prognosis subgroup(both P<0.05).Pearson correlation analysis showed that the levels of RDW and MPV in children with intraventricular hemorrhage were positively correlated with the GOS score(r=0.589,0.602,both P<0.05).The area under OC curve(AUC)of RDW combined with MPV for predicting the adverse prognosis of intraventricular hemorrhage in premature infants was 0.502,the sensitivity was 0.963,and the specificity was 0.901.Conclusion RDW and MPV are associated with the prognosis of premature children with intraventricular hemorrhage,which is helpful for early prediction of prognosis in patients.