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血小板计数与早产儿视网膜病变的发生及治疗的关联——血小板减少症是一个危险因素吗?

The association of platelet counts with development and treatment for retinopathy of prematurity - is thrombocytopenia a risk factor?

作者信息

Choręziak Aneta, Szpecht Dawid, Chmielarz-Czarnocińska Anna, Pawłowska Irmina, Gotz-Więckowska Anna

机构信息

Department of Ophthalmology, Poznan University of Medical Sciences, Poznan, Poland.

Department of Neonatology, Poznan University of Medical Sciences, Poznan, Poland.

出版信息

Arch Med Sci. 2019 May 27;18(2):400-405. doi: 10.5114/aoms.2019.85386. eCollection 2022.

Abstract

INTRODUCTION

Thrombocytes may regulate the activity of vascular endothelial growth factor (VEGF), limiting neovascularization in retinopathy of prematurity (ROP). The aim of this study was to examine the role of platelet counts, thrombocytopenia, and infections in the pathogenesis of ROP.

MATERIAL AND METHODS

The study included 163 preterm infants diagnosed with ROP, comparing 76 patients who required treatment with 87 patients in whom ROP resolved spontaneously (control group). Further analysis concerned 52 patients in whom a first line treatment was sufficient to stop ROP progression, and 24 patients who required re-treatment.

RESULTS

A statistically significant difference was found in the occurrence of thrombocytopenia ( = 0.015), platelet counts before the diagnosis of ROP ( = 0.008), and the presence of late-onset infection ( = 0.007). The ROC curve analysis showed that the value of platelets above 232 × 10/l may stimulate spontaneous resolution of ROP. A significant difference between patients once treated and patients that required re-treatment was found in platelet count before the diagnosis of ROP ( = 0.017), platelet count before the first intervention ( = 0.013), and the number of transfusions ( = 0.042).

CONCLUSIONS

The results of the study confirm the association between ROP development and its severity with thrombocytopenia. While there were no differences in the occurrence of thrombocytopenia right after the birth, its episode before the diagnosis of ROP seems to be significant for ROP development. The deficiency of platelets prior to a treatment intervention may be associated with necessity of re-treatment.

摘要

引言

血小板可能调节血管内皮生长因子(VEGF)的活性,限制早产儿视网膜病变(ROP)中的新生血管形成。本研究的目的是探讨血小板计数、血小板减少症和感染在ROP发病机制中的作用。

材料与方法

该研究纳入了163例诊断为ROP的早产儿,将76例需要治疗的患者与87例ROP自发消退的患者(对照组)进行比较。进一步分析涉及52例一线治疗足以阻止ROP进展的患者和24例需要再次治疗的患者。

结果

在血小板减少症的发生率(P = 0.015)、ROP诊断前的血小板计数(P = 0.008)和迟发性感染的存在(P = 0.007)方面发现了统计学上的显著差异。ROC曲线分析表明,血小板值高于232×10⁹/L可能刺激ROP的自发消退。在ROP诊断前的血小板计数(P = 0.017)、第一次干预前的血小板计数(P = 0.013)和输血次数(P = 0.042)方面,一次治疗的患者和需要再次治疗的患者之间存在显著差异。

结论

研究结果证实了ROP的发生及其严重程度与血小板减少症之间的关联。虽然出生后立即发生血小板减少症的情况没有差异,但ROP诊断前的血小板减少发作似乎对ROP的发生具有重要意义。治疗干预前血小板的缺乏可能与再次治疗的必要性有关。

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