Bas-Suárez Maria Pilar, González-Luis Gema Esther, Saavedra Pedro, Villamor Eduardo
Department of Neonatology, Complejo Hospitalario Universitario Insular Materno-Infantil de Canarias, Las Palmas de Gran Canaria, Spain.
Neonatology. 2014;106(3):188-94. doi: 10.1159/000362432. Epub 2014 Jul 5.
Decreased platelet number and/or function are related to patent ductus arteriosus (PDA) in mice. Whether this is also the case in human infants remains controversial.
To investigate the association between platelet count nadir within the first 7 days of life and the rate of hemodynamically significant PDA (HSPDA), as well as the rate of response to the treatment with cyclooxygenase (COX) inhibitors.
This is a retrospective study of a cohort of 194 very low-birth-weight (VLBW) infants (<1,500 g) with gestational age <30 weeks. HSPDA was assessed by echocardiography on day 3 of life.
HSPDA was present in 105 infants (54.1%). Of these, 101 were treated with COX inhibitors. The treatment failure rate was 21.8%. Median platelet count nadir and rate of thrombocytopenia - defined as platelet count <150 × 10(9)/l and graded as mild (100 to <150 × 10(9)/l), moderate (50 to <100 × 10(9)/l) or severe (<50 × 10(9)/l) - within the first 2 days of life were not significantly associated with the presence of HSPDA on day 3. Moreover, low platelet counts, either on days 1-2 or 3-7, were not significantly associated with the rate of response to treatment with COX inhibitors.
Our data provide further evidence for the lack of association between platelet counts within the first days of life and either spontaneous or pharmacological closure of the ductus arteriosus in VLBW infants.
血小板数量减少和/或功能异常与小鼠动脉导管未闭（PDA）有关。在人类婴儿中是否也是如此仍存在争议。
研究出生后7天内血小板计数最低点与血流动力学显著的动脉导管未闭（HSPDA）发生率之间的关联，以及与环氧化酶（COX）抑制剂治疗反应率之间的关联。
这是一项对194例胎龄<30周、极低出生体重（VLBW）婴儿（<1500g）的队列进行的回顾性研究。在出生后第3天通过超声心动图评估HSPDA。
105例婴儿（54.1%）存在HSPDA。其中，101例接受了COX抑制剂治疗。治疗失败率为21.8%。出生后2天内血小板计数最低点的中位数和血小板减少率（定义为血小板计数<150×10⁹/L，并分为轻度（100至<150×10⁹/L）、中度（50至<100×10⁹/L）或重度（<50×10⁹/L））与出生后第3天HSPDA的存在无显著关联。此外，出生后第1 - 2天或第3 - 7天的低血小板计数与COX抑制剂治疗反应率无显著关联。
我们的数据进一步证明，出生后几天内的血小板计数与VLBW婴儿动脉导管的自发或药物性闭合之间缺乏关联。
