低未成熟血小板比例提示脓毒症或坏死性小肠结肠炎新生儿巨核细胞生成减少。

Low immature platelet fraction suggests decreased megakaryopoiesis in neonates with sepsis or necrotizing enterocolitis.

机构信息

Department of Neonatology, Charité-Universitätsmedizin Berlin, Berlin, Germany.

出版信息

J Perinatol. 2013 Aug;33(8):622-6. doi: 10.1038/jp.2013.21. Epub 2013 Feb 28.

DOI:10.1038/jp.2013.21

PMID:23448941

Abstract

OBJECTIVE

In order to conclude on the megakaryopoietic activity during thrombocytopenia in sepsis or necrotizing enterocolitis (NEC), we analyzed the immature platelet fraction (IPF).

STUDY DESIGN

Serial measurements of platelet counts and IPF in neonates with blood culture-proven late-onset sepsis (n=21) or surgical NEC (n=12) at T0: prior to the diagnosis of sepsis/NEC; T1: at diagnosis; T2: days 3 to 5 after onset; T3: days 8 to 12 after onset.

RESULT

In parallel to declining platelet counts, the median absolute IPF significantly decreased between T0 and T2 in neonates with sepsis or NEC. We found a significant positive correlation between the platelet count and absolute IPF (r=0.71; P<0.001). In patients with low IPF (<2 per nl), the platelet count did not subsequently increase. Neonates with NEC who died exhibited significantly lower IPF compared with survivors (P<0.05).

CONCLUSION

Low absolute IPF values during the course of neonatal sepsis/NEC suggest suppression of megakaryopoietic activity.

摘要

目的

为了确定脓毒症或坏死性小肠结肠炎（NEC）血小板减少期间的巨核细胞生成活性，我们分析了未成熟血小板分数（IPF）。

研究设计

对血培养证实患有晚发性败血症（n=21）或手术 NEC（n=12）的新生儿在 T0（脓毒症/NEC 诊断之前）、T1（诊断时）、T2（发病后 3 至 5 天）和 T3（发病后 8 至 12 天）进行血小板计数和 IPF 的连续测量。

结果

与血小板计数下降平行，败血症或 NEC 新生儿的绝对 IPF 中位数在 T0 至 T2 期间显著降低。我们发现血小板计数与绝对 IPF 之间存在显著正相关（r=0.71；P<0.001）。在 IPF<2 per nl 的患者中，血小板计数随后并未增加。与幸存者相比，死亡的 NEC 新生儿的 IPF 明显较低（P<0.05）。