患有肠衰竭相关肝病的早产儿的凝血酶生成
Thrombin Generation in Preterm Newborns With Intestinal Failure-Associated Liver Disease.
作者信息
Ghirardello Stefano, Raffaeli Genny, Scalambrino Erica, Cortesi Valeria, Roggero Paola, Peyvandi Flora, Mosca Fabio, Tripodi Armando
机构信息
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
出版信息
Front Pediatr. 2020 Aug 26;8:510. doi: 10.3389/fped.2020.00510. eCollection 2020.
Intestinal failure-associated liver disease (IFALD) affects one-fifth of neonates receiving parenteral nutrition (PN) for more than 2 weeks. We aimed to define the effect of IFALD on hemostasis of preterm infants. This is an ancillary analysis of a prospective study aimed at defining coagulation in preterm infants. We included neonates exposed to PN (at least 14 days), in full-enteral feeding. We compared thrombin generation in the presence of thrombomodulin, defined as endogenous thrombin potential-ETP, PT, aPTT between infants with IFALD vs. those without (controls), at birth, and after 30 days. IFALD was defined as conjugated bilirubin ≥1 mg/dl. We enrolled 92 preterm infants (32 IFALD; 60 controls). Cholestatic patients had a lower birthweight, longer exposure to PN, and longer hospitalization. Infants with IFALD showed longer median PT (12.8-vs.-12 sec; = 0.02) and aPTT (39.2-vs.-36.5 sec; = 0.04) than controls, with no difference in ETP. Despite prolonged PTs and aPTTs infants with IFALD had similar ETP than those without.
肠衰竭相关肝病（IFALD）影响五分之一接受肠外营养（PN）超过2周的新生儿。我们旨在确定IFALD对早产儿止血功能的影响。这是一项旨在确定早产儿凝血功能的前瞻性研究的辅助分析。我们纳入了接受PN（至少14天）且完全经口喂养的新生儿。我们比较了出生时和30天后，IFALD婴儿与非IFALD婴儿（对照组）在存在血栓调节蛋白的情况下的凝血酶生成情况，定义为内源性凝血酶潜力（ETP）、凝血酶原时间（PT）、活化部分凝血活酶时间（aPTT）。IFALD定义为结合胆红素≥1mg/dl。我们招募了92名早产儿（32名IFALD患儿；60名对照）。胆汁淤积患儿出生体重较低，接受PN的时间更长，住院时间更长。与对照组相比，IFALD婴儿的PT中位数更长（12.8秒对12秒；P = 0.02），aPTT更长（39.2秒对36.5秒；P = 0.04），而ETP无差异。尽管IFALD婴儿的PT和aPTT延长，但其ETP与非IFALD婴儿相似。
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