免疫性血小板减少症孕妇与新生儿血小板减少症发生的相关因素  

Correlation factor analysis of neonatal thrombocytopenia in pregnant women with immune thrombocytopenia

作　　者：徐琦[1,2] 梁梅英[1] 徐雪[1] 窦莎 宋庆华[1] 陈哲[1] 

机构地区：[1]北京大学人民医院妇产科,100044 [2]北京市西城区妇幼保健院

出　　处：《中国妇产科临床杂志》2016年第4期337-341,共5页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：首都临床特色应用研究(z21107001012032)

摘　　要：目的探讨免疫性血小板减少症（ITP）孕妇与新生儿血小板减少症（PIT）发生的相关因素。方法回顾性分析北京大学人民医院产科2008年1月至2014年11月诊治并分娩的107例（3例双胎）ITP孕妇的临床资料。根据出生后第1~5天新生儿血小板计数,将新生儿分为PIT组（血小板计数〈100×109/L,22例）和血小板正常组（88例）。比较两组孕妇的临床资料,并对新生儿PIT的发生与孕妇因素进行相关性分析。结果新生儿PIT组与血小板正常组孕妇年龄、ITP确诊孕周、妊娠期高血压疾病、妊娠期糖尿病、妊娠期血小板计数最低值、分娩前血小板计数、妊娠期是否使用激素或丙种球蛋白、分娩孕周及方式比较,差异均无统计学意义（P〉0.05）。多因素非条件logistic回归分析显示,新生儿PIT的发生与孕妇年龄、孕产次、妊娠期血小板计数最低值等因素无明显相关性（P〉0.05）。22例新生儿PIT中,出生日血小板减低16例（73%）,出生后第1~5天6例（27%）;出生日出现血小板最低值7例（32%）,出生后3日内出现20例（91%）。结论新生儿PIT的发生可能与ITP孕妇年龄、诊断时间、妊娠期血小板水平、妊娠期高血压疾病、妊娠期糖尿病、是否接受治疗及分娩方式无关。但应严密监测新生儿出生当日及5天内血小板水平,及早诊断。Objective To determine predictive factors of neonatal passive immune thrombocytopenia（PIT） in deliveries with immune thrombocytopenia（ITP）. Methods A retrospective study was performed for 107 pregnancies（three deliveries of twins） with ITP at Peking University People’s Hospital from January 2008 to November 2014. Based on the presence or absence neonatal platelet counts（platelet count〈100×109/L） between 15 days after birth, neonates were classified into two groups： neonatal PIT group（22 cases） and normal platelet group（88 cases）. Results The comparison of the two groups mainly focus on maternal clinic factors. These parameters were compared between neonatal with PIT group and without group, including maternal age, ITP diagnosis time, pregnancy complicated with pregnancy hypertension disease, gestational diabetes, the minimum platelet count during pregnancy, platelet count before delivery, maternal treatment with hormones or IVIG during pregnancy, gestational weeks and delivery route, and no significant difference was found（P 〉0.05）. A multivariance analysis was taken between disease of neonatal PIT group and maternal clinic factors. There was no significant correlation（P 〉0.05） among maternal clinic factors and neonatal PIT. Among 22 neonates with PIT, there were 16 neonates（73%） whose thrombocytopenia occurred on the same day of birth, and there are six neonates（27%） whose thrombocytopenia occurred on the first day to the fifth day of birth. The lowest blood platelet counts of 7 patients（32%） occur red in the birth day, and the lowest counts of 20 patients（91%）occurred within 3 days after birth. Conclusions The incidence of neonatal thrombocytopenia in pregnancy with immune thrombocytopenia was not found to have effect on maternal pregnancy platelet count, complications, treatment, and delivery route. Special blood platelet counts monitoring should be taken for these fetuses with maternal ITP in five days after birth.

关 键 词：免疫性血小板减少症 新生儿血小板减少症 相关因素 

分 类 号：R722.1[医药卫生—儿科]