血小板参数对超低出生体质量儿支气管肺发育不良的预测价值  

Predictive value of platelet parameters for bronchopulmonary dysplasia in extremely low birth weight infants

作　　者：高旭 刘会领 王昕 公春梅 王杰芳 李桂芳 GAO Xu;LIU Huiling;WANG Xin;GONG Chunmei;WANG Jiefang;LI Guifang(Department of Neonatology,Cangzhou People's Hospital,Cangzhou,Hebei 061000,China)

机构地区：[1]沧州市人民医院新生儿科,河北沧州061000

出　　处：《安徽医药》2025年第4期810-814,共5页Anhui Medical and Pharmaceutical Journal

基　　金：沧州市科技计划自筹经费项目(23244102021)。

摘　　要：目的探讨血小板参数对超低出生体质量儿(ELBW)支气管肺发育不良的预测价值。方法回顾性分析沧州市人民医院2019年11月至2023年6月收治的,在出生后2 h内转至新生儿重症监护室(NICU)且体质量低于1000 g、住院时间≥28 d的ELBW的临床资料。据入组ELBW是否患支气管肺发育不良(BPD)分为BPD组与非BPD组。收集整理纳入研究的ELBW的一般临床资料及不同时间点血小板计数、血小板压积(PCT)、血小板分布宽度(PDW)、平均血小板体积(MPV)。结果共纳入ELBW 62例,其中BPD组24例,非BPD组38例。两组在胎龄、住院时间、机械通气时间、早产儿视网膜病变(ROP)发生率、母孕期高血压比例指标上差异有统计学意义(P<0.05)。BPD组病儿生后第2周末血小板计数为199.50(149.50,239.00)×10^(9)/L高于非BPD组第2周末的139.00(113.25,173.25)×10^(9)/L(P<0.05)。多因素logistic回归分析结果表明,生后第2周末血小板计数、住院时间及机械通气时间是ELBW发生BPD的独立危险因素(P<0.05)。ROC曲线分析显示生后第2周末血小板计数的最佳截断值为180×10^(9)/L,曲线下面积0.70,灵敏度66.7%,特异度71.1%,约登指数为0.38;住院时间的最佳截断值为83.5 d,曲线下面积0.75,灵敏度58.3%,特异度86.8%,约登指数为0.45;机械通气时间的最佳截断值为191.5 h,曲线下面积0.77,灵敏度70.8%,特异度81.6%,约登指数为0.52。结论生后第2周末较高的血小板计数、较长的住院时间及机械通气时间是ELBW发生BPD的独立危险因素,血小板参数对ELBW BPD具有良好的预测价值。Objective To explore the predictive value of platelet parameters in bronchopulmonary dysplasia in extremely low birth weight infants.Methods A retrospective analysis was performed for the clinical data of extremely low birth weight infants admitted to Cangzhou People's Hospital from November 2019 to June 2023 and transferred to the neonatal intensive care unit(NICU)within 2 hours after birth,with a weight of less than 1000 g and a hospital stay longer than or equal to 28 days.The babies were assigned into bronchopulmonary dysplasia(BPD)group and non-BPD group according to whether they had BPD or not.General clinical data and platelet parameters at different time points,including platelet count,plateletcrit(PCT),platelet distribution width(PDW)and mean platelet volume(MPV),were collected.Results A total of 62 extremely low birth weight infants were included in this study,including 24 in the BPD group and 38 in the non-BPD group.There were significant differences in gestational age,length of hospital stay,duration of mechanical ventilation,incidence of retinopathy of prematurity(ROP)and proportion of maternal hypertension during pregnancy between the two groups(P<0.05).The platelet count of the BPD group was significantly higher than that of the non-BPD group[199.50(149.50,239.00)×10^(9)/L vs.139.00(113.25,173.25)×10^(9)/L]at the end of the second week of life(P<0.05).The results of multivariate logistic regression analysis showed that platelet count,length of hospital stay and duration of mechanical ventilation at the end of the second week of life were independent risk factors for BPD in extremely low birth weight infants(P<0.05).ROC curve analysis showed that at the end of the second week of life the optimal cut-off value of platelet count was 180×10^(9)/L,the area under the curve 0.70,the sensitivity 66.7%,the specificity 71.1%,and the Youden index 0.38;the optimal cut-off value of length of hospital stay was 83.5 d,the area under the curve 0.75,the sensitivity 58.3%,the specificity 86.8%,and the Youden inde

关 键 词：超低出生体质量儿 支气管肺发育不良 血小板参数 早产儿 机械通气 

分 类 号：R722.6[医药卫生—儿科]