Zhong Junyan, Lin Binchun, Fu Yongping, Yu Yanliang, Zhao Jie, Zhao Depeng, Yang Chuanzhong, Chen Xueyu
Department of Neonatology, Shenzhen Maternity and Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical University, Shenzhen, China.
Department of Reproductive Medicine, Shenzhen Maternity and Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical University, Shenzhen, China.
Front Pediatr. 2021 Oct 11;9:729461. doi: 10.3389/fped.2021.729461. eCollection 2021.
Platelet-rich thrombosis leads to the occlusion of arteries. Whether the association between platelet count and closure of hemodynamically significant patent ductus arteriosus (hsPDA) exists remains inconclusive. Given that neonatal platelet count is significantly affected by infection, this study aims to evaluate the association of platelet parameters before ibuprofen treatment with the closure of hsPDA in very low birth weight (VLBW) infants without concurrent infection. A retrospective study was conducted at the NICU of Shenzhen Maternity and Child Healthcare Hospital from January 2016 to August 2020. VLBW infants diagnosed with hsPDA, treated with oral ibuprofen and without concurrent infection were included in this study. The platelet parameters were retrieved from the whole-blood test routinely performed within 24 h before starting treatment of oral ibuprofen. A multiple regression model was built to evaluate the association between platelet parameters before ibuprofen treatment and successful closure of hsPDA. A total of 129 premature infants with hsPDA were analyzed in this study. After oral ibuprofen treatment, successful closure of hsPDA was achieved in 70 (54.3%) infants. The gestational age at birth and birth weight in infants with successful or failed closure of hsPDA after ibuprofen treatment were 28.3 vs. 27.6 weeks ( = 0.016) and 1,120 vs. 960 g ( = 0.043), respectively. The rate of mechanical ventilation in infants with successful closure of hsPDA was significantly lower compared to those with failed closure of hsPDA, 31.4 vs. 54.2%, = 0.014. The platelet count in infants with successful closure of hsPDA after ibuprofen treatment was significantly higher compared to those with failed closure of hsPDA, 212 vs. 183 (in a unit of 10/L), respectively ( = 0.024). Multivariate logistic regression analysis showed that a higher platelet count (≥181 × 10/L) before ibuprofen treatment was independently associated with successful closure of hsPDA [odds ratio 2.556, 95% confidence interval (1.101-5.932), = 0.029]. The findings in this study suggest that a higher platelet count before oral ibuprofen treatment may predict the probability of successful closure of hsPDA in VLBW infants.
富含血小板的血栓形成会导致动脉闭塞。血小板计数与血流动力学显著的动脉导管未闭（hsPDA）闭合之间是否存在关联尚无定论。鉴于新生儿血小板计数受感染影响显著，本研究旨在评估在无并发感染的极低出生体重（VLBW）婴儿中，布洛芬治疗前血小板参数与hsPDA闭合之间的关联。2016年1月至2020年8月在深圳市妇幼保健院新生儿重症监护病房进行了一项回顾性研究。本研究纳入了诊断为hsPDA、接受口服布洛芬治疗且无并发感染的VLBW婴儿。血小板参数取自开始口服布洛芬治疗前24小时内常规进行的全血检测。建立多元回归模型以评估布洛芬治疗前血小板参数与hsPDA成功闭合之间的关联。本研究共分析了129例患有hsPDA的早产儿。口服布洛芬治疗后，70例（54.3%）婴儿hsPDA成功闭合。布洛芬治疗后hsPDA闭合成功或失败的婴儿的出生孕周和出生体重分别为28.3周对27.6周（P = 0.016）和1120克对960克（P = 0.043）。hsPDA闭合成功的婴儿机械通气率显著低于闭合失败的婴儿，分别为31.4%对54.2%，P = 0.014。布洛芬治疗后hsPDA闭合成功的婴儿血小板计数显著高于闭合失败的婴儿，分别为212对183（单位为10⁹/L）（P = 0.024）。多因素logistic回归分析显示，布洛芬治疗前较高的血小板计数（≥181×10⁹/L）与hsPDA成功闭合独立相关[比值比2.556，95%置信区间（1.101 - 5.932），P = 0.029]。本研究结果表明，口服布洛芬治疗前较高的血小板计数可能预测VLBW婴儿hsPDA成功闭合的概率。
