Hsieh Po-Yu, Hsu Kai-Hsiang, Chiang Ming-Chou, Hsu Jen-Fu, Chu Shih-Ming, Lien Reyin
Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan.
Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Science, Chang Gung University, Taoyuan, Taiwan.
Pediatr Neonatol. 2023 Jan;64(1):68-74. doi: 10.1016/j.pedneo.2022.06.009. Epub 2022 Sep 24.
There is growing recognition of the role of platelets in inflammation and immune responses, and platelets have been associated with various cardiovascular diseases. It is also known that neonatal morbidities are related to overall platelet activity, and platelet parameters may have the potential to predict morbidities and mortality in preterm infants. This study aimed to assess the initial platelet parameters and the association with major morbidities and mortality in preterm neonates.
We retrospectively reviewed data from very preterm neonates with a gestational age (GA) <32 weeks who were admitted between June 2020 and May 2021 for platelet parameters (counts, mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (platelet counts x MPV/10000(%)) at birth. Major morbidities included early- onset sepsis (EOS) ≤3 days after birth, severe intraventricular hemorrhage (IVH) grade ≥3, and early or overall mortality.
A total of 197 very preterm neonates were studied. Their mean (±SD) GA was 28.0 ± 2.4 weeks, birth weight was 990 ± 293 g, platelet counts were 245 ± 81 x1000/μL, MPV was 10.0 ± 0.7 fl, PDW was 11.0 ± 1.6 fl, and plateletcrit was 0.24 ± 0.08%. MPV had a weak negative correlation with both GA (r = -0.234, p = 0.001) and BW (r = -0.343, p <0.001). A lower plateletcrit was associated with EOS (0.14 (0.04-0.22) % vs. 0.23 (0.19-0.30) %, p = 0.027), severe IVH ≤7 days after birth (0.18 (0.14-0.27) % vs. 0.23 (0.20-0.30) %, p = 0.022), and early and overall mortality (0.15 (0.20-0.30) % vs. 0.23 (0.20-0.30) %, p = 0.049; 0.20 ± 0.09 % vs. 0.25 ± 0.07 %, p = 0.008).
A lower plateletcrit within 24 hours of birth was associated with EOS, severe IVH ≤7 days after birth, and first-week and overall mortality in very preterm neonates.
血小板在炎症和免疫反应中的作用日益受到重视，并且血小板已与多种心血管疾病相关联。还已知新生儿发病率与总体血小板活性有关，血小板参数可能具有预测早产儿发病率和死亡率的潜力。本研究旨在评估早产儿出生时的初始血小板参数及其与主要发病率和死亡率的关联。
我们回顾性分析了2020年6月至2021年5月期间收治的孕周（GA）<32周的极早产儿的资料，记录其出生时的血小板参数（计数、平均血小板体积（MPV）、血小板分布宽度（PDW）和血小板压积（血小板计数×MPV/10000（%））。主要发病率包括出生后≤3天的早发型败血症（EOS）、≥3级的重度脑室内出血（IVH）以及早期或总体死亡率。
共研究了197例极早产儿。他们的平均（±标准差）孕周为28.0±2.4周，出生体重为990±293克，血小板计数为245±81×1000/μL，MPV为10.0±0.7飞升，PDW为11.0±1.6飞升，血小板压积为0.24±0.08%。MPV与孕周（r = -0.234，p = 0.001）和出生体重（r = -0.343，p <0.001）均呈弱负相关。较低的血小板压积与EOS（0.14（0.04 - 0.22）% 对 0.23（0.19 - 0.30）%，p = 0.027）、出生后≤7天的重度IVH（0.18（0.14 - 0.27）% 对
