GPⅡb/Ⅲa在新生儿血小板减少症中的表达及临床意义

Expression and Clinical Significance of Glycoprotein Ⅱb/Ⅲa in Newborns with Neonatal Thrombocytopenic

目的 探讨血清血小板膜糖蛋白特异性抗体(glycoproteinⅡb/Ⅲa,GPⅡb/Ⅲa)在新生儿血小板减少症(neonatal thrombocytopenic,NT)患儿中的表达及临床意义。方法 将银川市第一人民医院住院的158例患儿作为研究对象,其中确诊的62例NT患儿为观察组,另外96例非NT患儿为对照组,采集患儿入院时的血清用ELISA法检测GPⅡb/Ⅲa的表达,比较两组之间GPⅡb/Ⅲa表达水平的差异以及对NT患儿预后的预测。结果 观察组和对照组GPⅡb/Ⅲa表达水平相比差异有统计学意义(Z=-5.320,P<0.05);胎龄、出生体质量、维生素K1注射次数、羊水污染、缺氧、出血、感染、呼吸机支持、吸氧、凝血异常、部分炎性因子等相关指标在两组间分布差异均有统计学意义(P均<0.05)。GPⅡb/Ⅲa(OR=17.469)、宫内感染(OR=21.018)、新生儿败血症(OR=5.474)、CRP是否升高(OR=16.972)是NT患儿的危险因素(P均<0.05)。ROC曲线分析GPⅡb/Ⅲa预测NT的最大约登指数取最佳截断值为1 470.25 U·mL-1。在观察组中,预后良好与预后不良的患儿GPⅡb/Ⅲa表达水平差异无统计学意义(Z=-1.239,P>0.05)。结论 GPⅡb/Ⅲa在NT患儿中的表达较低,是发生NT的独立危险因素,但对NT患儿的预后预测没有临床意义。

Objective To investigate the expression and clinical significance of serum platelet membrane glycoprotein-specific antibodies(glycoproteinⅡb/Ⅲa,GPⅡb/Ⅲa)in neonatal thrombocytopenic(NT)children.Methods A total of 158 newborns admitted to the First People’s Hospital of Yinchuan were taken as the research objects,of which 62 newborns with NT were confirmed as the observation group,and 96 non-NT newborns were randomly selected as the control group.Serum was collected at the time of admission.The expression of GPⅡb/Ⅲa was detected by ELISA method to compare the difference in GPⅡb/Ⅲa expression levels between the two groups and the prediction of the prognosis of newborns with NT.Results The expression level of GPⅡb/Ⅲa in the observation group was significantly different from that in the control group(Z=-5.320,P<0.05).There were significant differences in the distribution of related indicators such as gestational age,birth weight,number of vitamin K1 injections,amniotic fluid pollution,hypoxia,bleeding,infection,ventilator support,oxygen inhalation,coagulation abnormalities,and some inflammatory factors between the two groups(P all<0.05).Among them,GPⅡb/Ⅲa(OR=17.469),intrauterine infection(OR=21.018),neonatal sepsis(OR=5.474),and CRP(OR=16.972)were independent risk factors for newborns with NT(P all<0.05).Through ROC curve analysis,GPⅡb/Ⅲa predicted that the maximum Jordan index of NT had the best cut-off value of 1470.25 U·mL-1.In the observation group,there was no significant difference in GPⅡb/Ⅲa expression levels between newborns with good prognosis and poor prognosis(Z=-1.239,P>0.05).Conclusion The expression of GPⅡb/Ⅲa in newborns with NT is reduced,which is an independent risk factor for the occurrence of NT and has no clinical significance for the prognosis of newborns with NT.