Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, 960-1295, Japan.
Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan.
Ital J Pediatr. 2020 Apr 29;46(1):54. doi: 10.1186/s13052-020-0815-7.
Although disseminated intravascular coagulation (DIC) is a critical disease, there is few gold standard interventions in neonatal medicine. The aim of this study is to reveal factors affecting neonatal DIC at birth and to assess the effectiveness of rTM and FFP for DIC in neonates at birth.
We retrospectively evaluated DIC score on the first day of life in neonates with underlying conditions associated with DIC. DIC in neonates was diagnosed according to Japan Society of Obstetrical, Gynecological & Neonatal Hematology 2016 neonatal DIC criteria.
Comparing neonates with DIC scores of ≥3 (n = 103) to those < 3 (n = 263), SGA, birth asphyxia, low Apgar score, hemangioma, hydrops, PIH, and PA were statistically increased. Among 55 neonates underwent DIC treatment, 53 had birth asphyxia and 12 had intraventricular hemorrhage. Forty-one neonates received FFP or a combination of FFP and antithrombin (FFP group), while 14 neonates received rTM or a combination of rTM, FFP, and antithrombin (rTM group). DIC score before treatment in the rTM group was significantly higher than in the FFP group (4.7 vs 3.6, P < 0.05). After treatment, DIC scores in both groups were significantly reduced on Day 1 and Day 2 (P < 0.05).
Among various factors associated with DIC in neonates at birth, birth asphyxia is particularly significant. Furthermore, rTM in combination with FFP therapy was effective for neonatal DIC at birth.
弥散性血管内凝血（DIC）虽是一种严重疾病，但新生儿医学领域中几乎没有金标准干预措施。本研究旨在揭示新生儿出生时发生 DIC 的影响因素，并评估重组组织型纤溶酶原激活物（rTM）和新鲜冰冻血浆（FFP）对新生儿 DIC 的疗效。
我们回顾性评估了伴有 DIC 相关基础疾病的新生儿出生后第 1 天的 DIC 评分。根据日本妇产科新生儿血液学会 2016 年新生儿 DIC 标准诊断新生儿 DIC。
与 DIC 评分≥3 的新生儿（n=103）相比，DIC 评分<3 的新生儿（n=263）中，SGA、出生窒息、低 Apgar 评分、血管瘤、水肿、子痫前期和肺动脉高压更为常见。在 55 例接受 DIC 治疗的新生儿中，53 例有出生窒息，12 例有脑室出血。41 例新生儿接受 FFP 或 FFP 联合抗凝血酶（FFP 组）治疗，14 例新生儿接受 rTM 或 rTM、FFP 和抗凝血酶（rTM 组）联合治疗。rTM 组治疗前的 DIC 评分明显高于 FFP 组（4.7 比 3.6，P<0.05）。治疗后，两组在第 1 天和第 2 天的 DIC 评分均显著降低（P<0.05）。
在新生儿出生时发生 DIC 的各种相关因素中，出生窒息尤为重要。此外，rTM 联合 FFP 治疗对新生儿出生时的 DIC 有效。
