新生儿类白血病反应36例临床分析  

Neonatal leukemoid reaction:clinical analysis of 36 cases

作　　者：周珍慧 李秋平 董丽[1] 花少栋 Zhou Zhenhui;Li Qiuping;Dong Li;Hua Shaodong(Neonatal Intensive Care Unit,Faulty of Pediatrics,the Seventh Medical Center of PLA General Hospital,National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology,Beijing Key Laboratory of Pediatric Organ Failure,Beijing 100700,China)

机构地区：[1]解放军总医院第七医学中心儿科医学部新生儿重症监护室,出生缺陷防控关键技术国家工程实验室,儿童器官功能衰竭北京市重点实验室,北京100700

出　　处：《中华新生儿科杂志（中英文）》2023年第4期230-233,共4页Chinese Journal of Neonatology

基　　金：国家重点研发计划(2021YFC2701700)。

摘　　要：目的探讨新生儿类白血病反应(neonatal leukemoid reaction,NLR)的临床特点。方法回顾性选择2010年9月至2022年1月解放军总医院第七医学中心儿科医学部新生儿重症监护室收治的NLR患儿为NLR组,按1∶2选取同期入院无NLR且与NLR患儿胎龄及出生体重匹配的新生儿为对照组。收集患儿胎龄、出生体重、母亲孕期并发症情况、白细胞计数最大值、中性粒细胞占比、C反应蛋白、血红蛋白、血小板计数、疾病诊断等相关信息,并应用SPSS 21.0统计软件对两组患儿数据进行比较。结果NLR组36例,对照组72例。NLR组外周血中均发现幼稚粒细胞,白细胞计数高于对照组[61.7(54.2,90.6)×10^(9)/L比19.6(14.2,27.3)×10^(9)/L],差异有统计学意义(P<0.001);两组中性粒细胞占比、血红蛋白、血小板、C反应蛋白差异无统计学意义(P>0.05)。NLR组阴道分娩、羊水污染和新生儿败血症比例高于对照组(69.4%比38.9%,19.4%比5.6%,47.2%比8.3%),母亲妊娠期糖尿病、妊娠期高血压和产前使用糖皮质激素比例低于对照组(11.1%比31.9%,2.8%比19.4%,50.0%比73.6%),差异均有统计学意义(P<0.05);两组胎膜早破、出生窒息、颅内出血、肺出血、细菌性脑膜炎及支气管肺发育不良发生率差异无统计学意义(P>0.05)。结论NLR患儿常合并败血症,及早防治母亲孕期并发症、积极控制感染对防治NLR的发生有重要意义。Objective To study the clinical characteristics of neonatal leukemoid reaction(NLR).Methods The newborns with NLR admitted to the neonatal intensive care unit of the Seventh Medical Center of PLA General Hospital from September 2010 to January 2022 were selected as the observation group,and the newborns without NLR,who were admitted to the Hospital at the same time and matched with gestational age and birth weight of the NLR newborns were selected as the control group at a ratio of 1∶2.The gestational age,birth weight,maternal complications,maximum leukocyte count,percentage of neutrophils,C-reactive protein,hemoglobin,platelet count,disease diagnosis and other relevant information of the newborns were recorded,and SPSS 21.0 statistical software was applied to compare the data of the two groups of newborns.Results A total of 36 cases were in the observation group and 72 cases in the control group.Naive granulocytes were found in the peripheral blood of all patients in the observation group,and leukocyte count was higher than that of the control group[61.7(54.2,90.6)×10^(9)/L vs.19.6(14.2,27.3)×10^(9)/L],the difference was statistically significant(P<0.001),but there was no statistically significant difference in the percentage of neutrophils,hemoglobin,platelets,and C-reactive protein between the two groups(P>0.05).The proportion of vaginal delivery,meconium-stained amniotic fluid,and neonatal sepsis in the observation group were higher than that in the control group[69.4%(25/36)vs.38.9%(28/72),19.4%(7/36)vs.5.6%(4/72),47.2%(17/36)vs.8.3%(6/72)],and the proportion of gestational diabetes mellitus,gestational hypertension and prenatal use of glucocorticoid was lower than that in the control group,with statistical significance(P<0.05).There was no significant difference in the incidence of premature rupture of membranes,neonatal asphyxia,intracranial hemorrhage,pulmonary hemorrhage,bacterial meningitis,and bronchopulmonary dysplasia between the two groups(P>0.05).Conclusions Newborns with NLR are frequently com

关 键 词：新生儿类白血病反应 感染 败血症 羊水污染 

分 类 号：R722.1[医药卫生—儿科]