不同胎龄早产儿颅内出血PT、APTT、DD、FIB水平与颅内出血的相关性研究  

Study on the correlation between PT,APTT,DD,and FIB levels and intracranial hemorrhage in premature infants with different gestational ages

作　　者：闫学爽 肖娜娜[1] 陈源 吴萍 李娅 严士杰[1] YAN Xueshuang;XIAO Nana;CHEN Yuan;WU Ping;LI Ya;YAN Shijie(Department of Neonatology,Baoding Second Central Hospital,Zhuozhou,Hebei,China,072750;Department of Ultrasound,Baoding Second Central Hospital,Zhuozhou,Hebei,China,072750)

机构地区：[1]保定市第二中心医院新生儿科,河北涿州072750 [2]保定市第二中心医院超声科,河北涿州072750

出　　处：《分子诊断与治疗杂志》2023年第7期1221-1224,共4页Journal of Molecular Diagnostics and Therapy

基　　金：保定市科技计划项目(2241ZF199)。

摘　　要：目的研究不同胎龄早产儿颅内出血凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D⁃二聚体(DD)、纤维蛋白原(FIB)的水平特点及其与颅内出血的相关性。方法以2019年1月至2021年12月某医院134例颅内出血早产儿作为研究对象,其中早期早产儿(26~33+6周)58例、晚期早产儿(34~36+6周)76例,以1∶1比例取同期健康新生儿134名为对照组,分析不同胎龄新生儿PT、APTT、DD、FIB水平特点,并观察PT、APTT、DD、FIB水平与颅内出血程度的相关性。新生儿PT、APTT、DD、FIB水平采用全自动凝血分析仪监测,颅内出血情况采用头颅超声或磁共振成像(MRI)检查判断。结果早产儿颅内出血者PT、APTT、DD水平均显著高于健康对照组,FIB水平显著低于健康对照组,差异均有统计学意义(t=3.542、11.086、9.062、4.886,P<0.05)。早期早产儿PT、APTT、DD水平均显著高于晚期早产儿,FIB水平显著低于晚期早产儿,差异均有统计学意义(t=2.094、5.343、3.644、3.015,P<0.05)。晚期早产儿颅内出血严重程度轻于早期早产儿颅内出血,差异有统计学意义(χ^(2)=8.689,P<0.05)。颅内出血早产儿PT、APTT、DD水平与颅内出血严重程度呈显著正相关(r=0.076、0.817、0.610,P<0.05),FIB水平与颅内出血严重程度呈显著负相关(r=-0.593,P<0.05)。结论早产儿颅内出血多存在凝血功能紊乱,PT、APTT、DD水平升高,FIB水平降低,胎龄越小、凝血指标变化越显著,而且PT、APTT、DD、FIB水平与颅内出血严重程度具有显著相关性。Objective To study the characteristics of prothrombin time(PT),activated partial thromboplastin time(APTT),D⁃dimer(DD)and fibrinogen(FIB)levels in premature infant with intracrani⁃al hemorrhage at different gestational ages and their correlation with intracranial hemorrhage.Methods 134 cases of premature infant with intracranial hemorrhage in a hospital from January 2019 to December 2021 were taken as the observation objects,including 58 cases of early preterm infants(26⁃33+6 weeks)and 76 cases of late preterm infants(34⁃36+6 weeks).134 healthy newborns in the same period were taken as the control group at a ratio of 1∶1.The characteristics of PT,APTT,DD,and FIB levels in premature infants of different gestational ages were analyzed,and the correlation between PT,APTT,DD and FIB levels and the degree of intracranial hemorrhage was observed.Neonatal PT,APTT,DD,FIB levels were monitored by automatic co⁃agulation analyzer,intracranial hemorrhage was judged by cranial ultrasound or magnetic resonance imaging(MRI).Results The levels of PT,APTT,and DD in the premature infants with intracranial hemorrhage were significantly higher than those in the healthy control group,and the level of FIB was significantly lower than that in the healthy control group(t=3.542,11.086,9.062,4.886,P<0.05).The PT,APTT and DD lev⁃els in early preterm infants were significantly higher than those in late preterm infants,FIB level was signifi⁃cantly lower than that of late preterm infants,the differences were statistically significant(t=2.094,5.343,3.644,3.015,P<0.05).The degree of intracranial hemorrhage in late preterm infants was lighter than the ear⁃ly preterm infants,the difference was statistically significant(χ^(2)=8.689,P<0.05).The levels of PT,APTT,and DD in premature infants with intracranial hemorrhage were significantly positively correlated with the se⁃verity of intracranial hemorrhage(r=0.076,0.817,0.610,P<0.05),and the level of FIB was significantly negatively correlated with the severity of intracranial hem

关 键 词：颅内出血 早产儿 凝血酶原 D⁃二聚体 纤维蛋白原 

分 类 号：R722.6[医药卫生—儿科]