极/超低出生体重早产儿颅内出血影响因素及NLR、PLR、D-D水平变化分析  

Analysis of influencing factors of intracranial hemorrhage and changes of NLR,PLR and D-D levels in extremely/ultra-low birth weight premature infants

作　　者：汪志萍 闭宏娟[1] 李凌霄[1] WANG Zhiping;BI Hongjuan;LI Lingxiao(Neonatal Medical Center,Maternity and Child Healthcare of Guangxi Zhuang Autonomous Region,Guangxi,Nanning 530000,China)

机构地区：[1]广西壮族自治区妇幼保健院新生儿医疗中心,广西南宁530000

出　　处：《中国医药科学》2025年第2期40-44,共5页China Medicine And Pharmacy

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20201060)。

摘　　要：目的分析研究极/超低出生体重早产儿颅内出血影响因素及中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、D-二聚体(D-D)水平变化。方法回顾性选取2018年6月至2023年6月广西壮族自治区妇幼保健院收治的464例极/超低出生体重早产儿作为研究对象,根据有无颅内出血,分为出血组(n=88)与无出血组(n=376)。比较两组的NLR、PLR、D-D水平,采用单、多因素logistic回归分析极/超低出生体重早产儿颅内出血的影响因素,并绘制ROC曲线分析NLR、PLR、D-D水平对极/超低出生体重早产儿颅内出血的预测价值。结果出血组NLR、PLR、D-D水平高于无出血组,差异有统计学意义(P<0.05);多因素logistic回归分析显示,胎龄≤32周(OR=2.056)、阴道分娩(OR=1.982)、有窒息史(OR=1.766)、NLR升高(OR=2.059)、PLR升高(OR=2.109)以及D-D水平升高(OR=2.040)均是极/超低出生体重早产儿颅内出血的独立危险因素(P<0.05);ROC曲线分析结果显示,NLR、PLR、D-D水平及联合检测的曲线下面积(AUC)分别为0.836、0.836、0.802、0.947,联合检测优于单一检测。结论极/超低出生体重早产儿颅内出血受到多种因素影响,NLR、PLR、D-D水平可以成为极/超低出生体重早产儿颅内出血的辅助评估指标。Objective To analyze the influencing factors of intracranial hemorrhage and the changes of neutrophil to lymphocyte ratio(NLR),platelet and lymphocyte ratio(PLR)and D-dimer(D-D)levels in extremely/ultra-low birth weight premature infants.Methods From June 2018 to June 2023,464 cases of extremely/ultra-low birth weight premature infants admitted to the Maternity and Child Healthcare of Guangxi Zhuang Autonomous Region were selected as the research subjects,and were divided into bleeding group(n=88)and non-bleeding group(n=376)according to whether there was intracranial hemorrhage or not.The levels of NLR,PLR and D-D were compared between the two groups.Univariate and multivariate logistic regression was used to analyze the influencing factors of intracranial hemorrhage in extremely/ultra-low birth weight premature infants,and ROC curve was drawn to analyze the predictive value of NLR,PLR and D-D levels for intracranial hemorrhage in extremely/ultra-low birth weight premature infants.Results The levels of NLR,PLR and D-D in bleeding group were higher than those in non-bleeding group,and the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that gestational age≤32 weeks(OR=2.056),vaginal delivery(OR=1.982),asphyxia(OR=1.766),elevated NLR(OR=2.059),elevated PLR(OR=2.109),and elevated D-D levels(OR=2.040)were all independent risk factors for intracranial hemorrhage in extremely/ultra-low birth weight premature infants(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of NLR,PLR,D-D levels,and combined detection were 0.836,0.836,0.802,and 0.947,respectively,indicating that combined detection was superior to single detection.Conclusion Intracranial hemorrhage in extremely/ultra-low birth weight premature infants is influenced by multiple factors,and NLR,PLR,and D-D levels can serve as auxiliary evaluation indicators for intracranial hemorrhage in extremely/ultra-low birth weight premature infants.

关 键 词：早产儿 极/超低出生体重 颅内出血 中性粒细胞与淋巴细胞比值 血小板与淋巴细胞比值 D-二聚体 

分 类 号：R722.6[医药卫生—儿科]