早产儿脑室周围-脑室内出血凝血功能的探讨  

EXPLORATION OF COAGULATION FUNCTION IN PRETERM INFANTS WITH PREIVENTRICULAR-INTRAVENTRICULAR HEMORRHAGE

作　　者：范一斌[1] 周晓玉[1] 戈建军[1] 

机构地区：[1]南京医科大学附属南京市儿童医院,江苏南京210008

出　　处：《实用临床医药杂志》2005年第7期49-52,共4页Journal of Clinical Medicine in Practice

摘　　要：目的研究早产儿脑室周围-脑室内出血(PV-IVH)凝血功能的变化及其临床意义。方法44例PV-IVH早产患儿根据头颅B超检测结果,按病情轻重分为轻度(甲)、重度出血(乙)两组,各27、17例,并以未发生PV-IVH的早产儿19例作为对照(丙)组,测定其血浆中血管性血友病因子(vWF)、血小板α颗粒膜蛋白-140(GMP-140)、D-二聚体(D-D)的含量以及活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(Fbg)的变化。结果PV-IVH患儿血浆vWF、GMP-140和D-D的含量较丙组显著升高,并且随着病情的加重而升高(P<0.01);乙组的APTT、PT和TT较甲组和丙组明显升高,Fbg明显下降(P<0.01或P<0.05);甲组与丙组比较APTT和TT有明显差异(P<0.05);各组血小板数值均在正常值范围内,无显著性差异(P>0.05)。结论PV-IVH患儿体内存在血管内皮细胞损伤、血小板活化,并且引起凝血与纤溶系统功能紊乱,出血严重的早产儿尤为明显。Objective To study the change of coagulation function and to evaluate its clinical significance in preterm infants with preiventricular-intraventricular hemorrhage （PV-IVH）. Methods 44 preterm infants with PV-IVH diagnosed in cranial Doppler ultrasonograph were divided into group A （27 cases） and group B（17 cases）, group C （19 cases） without PV-IVH as control. The levels of plasma von Willebrand factor（vWF）, Platelet αGranule membrane protein 140（GMP- 140）, D？ dimer （D-D） and the changes of activated partial thromboplastin time （APTT）, prothrombin time （PT）, thrombin time （TT）, fibrinogen （Fbg） were measured. Results The levels of plasma vWF, GMP-140 and D-D in preterm infants with PV-IVH were significantly higher than those in group C, and they had strong relationship with the degree of severity（ P 〈0.01）. APTT, PT and TT were significantly increased and Fbg was decreased in group B（ P 〈 0.01 or P 〈 0.05）. There were significant differences of AKTT and TT between group A and C（ P 〈0.05）. There was a little difference in the number of platelet among the three groups （ P 〉0.05）, which was normal. Conclusion With the injury of vascular endothelium and the activation of platelet, there is dysfunction of coagulation and fibrinolytic systems in the preterm infants with PV-IVH, especially in severe.

关 键 词：早产儿 脑室周围-脑室内出血 凝血 纤溶 

分 类 号：R722.6[医药卫生—儿科]