Hovgesen Nadia Thrane, Hviid Claus V B, Grevsen Alexander K, Hansen Anne Kirkeby, Hvas Anne-Mette
Thrombosis and Hemostasis Research Unit, Department of Clinical Biochemistry Aarhus University Hospital Aarhus Denmark.
Neonatal Intensive Care Unit, Department of Pediatrics and Adolescent Medicine Aarhus University Hospital Aarhus Denmark.
Res Pract Thromb Haemost. 2022 Aug 1;6(5):e12751. doi: 10.1002/rth2.12751. eCollection 2022 Jul.
A reduced platelet function might contribute to the longer bleeding time seen in preterm neonates. However, the previously used platelet function testing in neonates is limited due to methodological limitations, mainly caused by difficulties in obtaining adequate blood volume. Therefore, the platelet function in preterm neonates is sparsely investigated. The aim of this study was to compare platelet function in preterm neonates at birth and at expected term age with platelet function in term neonates at birth.
We included 43 preterm neonates born at gestational age (GA) 28 + 0 to 34 + 0 and 21 term neonates born at GA 38 + 0 to 41 + 0. Within the first 24 hours of life, 1-1.5 mL peripheral blood was obtained and for preterm neonates, resampling was performed at expected term age (GA 38 + 0 to 41 + 0). Platelet function testing included impedance aggregometry and platelet activation measured by flow cytometry. In addition, platelet count was determined.
Platelet count and platelet activation were reduced in preterm neonates compared with term neonates at birth, but we found no difference in impedance aggregometry at birth. At expected term age, platelet count and aggregation exceeded term levels, but platelet activation remained impaired in the preterm.
Preterm neonatal function is decreased at birth and does not seem to reach term levels during the first 4 to 13 weeks of life.
血小板功能降低可能是早产新生儿出血时间延长的原因之一。然而，由于方法学上的局限性，此前用于新生儿的血小板功能检测受到限制，主要是因为难以获取足够的血量。因此，对早产新生儿的血小板功能研究较少。本研究旨在比较早产新生儿出生时及预期足月时的血小板功能与足月新生儿出生时的血小板功能。
我们纳入了43例胎龄为28⁺⁰至34⁺⁰周的早产新生儿和21例胎龄为38⁺⁰至41⁺⁰周的足月新生儿。在出生后的头24小时内，采集1 - 1.5 mL外周血，对于早产新生儿，在预期足月时（胎龄38⁺⁰至41⁺⁰周）再次采血。血小板功能检测包括阻抗聚集法和通过流式细胞术测量血小板活化。此外，还测定了血小板计数。
与足月新生儿出生时相比，早产新生儿出生时的血小板计数和血小板活化降低，但我们发现出生时阻抗聚集法无差异。在预期足月时，早产新生儿的血小板计数和聚集超过足月水平，但血小板活化仍受损。
早产新生儿出生时功能降低，在出生后的4至13周内似乎未达到足月水平。
