早产儿出生后凝血指标与坏死性小肠结肠炎发病的相关性  

Correlation between postnatal coagulation indexes and incidence of necrotizing enterocolitis in preterm infants

作　　者：杜晓斌[1] 胡博[1] 戴春娟[1] 王金虎[1] 赵旭稳 杨福江 DU Xiaobin;HU Bo;DAI Chunjuan(Department of Neonatal Surgery,Tianjin Children’s Hospital,Tianjin 300314,CHINA)

机构地区：[1]天津市儿童医院新生儿外科,300314

出　　处：《江苏医药》2022年第10期1015-1018,1022,共5页Jiangsu Medical Journal

基　　金：天津市医学重点学科(专科)建设项目(TJYXZDXK-040A);天津市儿童医院发展基金计划项目(Y2020006)。

摘　　要：目的探讨早产儿出生后凝血指标与坏死性小肠结肠炎(NEC)发病的相关性。方法选取Bell分期≥Ⅱ期的早产NEC患儿43例为病例组,同期胎龄相近未发生NEC的早产儿43例为对照组。比较两组出生后24 h内的凝血相关指标。对病例组中NEC发病日龄与凝血指标进行组内相关性分析。结果病例组纤维蛋白原(Fib)水平、凝血酶原时间的国际标准化比值(PT-INR)和APTT均高于对照组(P<0.05),而两组间D-D、纤维蛋白降解产物、凝血酶时间及凝血酶原时间比较差异无统计学意义(P>0.05)。病例组根据凝血指标化验行冷沉淀或血浆输注比例高于对照组(44.2%vs.23.3%)(P<0.05)。病例组患儿APTT与NEC发病日龄呈负相关(r=-0.782,P<0.05)。结论早产儿出生后凝血指标PT-INR、Fib及APTT与NEC的发病相关。Objective To analyze the correlation between the postnatal coagulation indexes and the incidence of necrotizing enterocolitis(NEC)in preterm infants.Methods Forty-three preterm infants with NEC in Bell stage≥Ⅱ(group A)and 43 preterm infants with similar gestational age without NEC during the same period(group B)were selected.The blood coagulation-related indexes within 24 hours after birth were compared between the two groups.The correlation between the age of NEC onset and coagulation indexes in group A was analyzed.Results The level of fibrinogen(Fib),the international normalized ratio of prothrombin time(PT-INR)and APTT in group A were higher than those in group B(P<0.05).There were no significant differences in D-D,fibrin degradation products,thrombin time and PT between the two groups(P>0.05).The percentage of the infants with cryoprecipitate or plasma transfusion in group A was higher than that in group B(44.2%vs.23.3%)(P<0.05).APTT was negatively correlated with the age at onset of NEC in group A(r=-0.782,P<0.05).Conclusion The coagulation indexes PT-INR,Fib and APTT are related to the occurrence of NEC in preterm infants.

关 键 词：坏死性小肠结肠炎 凝血指标 早产儿 

分 类 号：R722[医药卫生—儿科]