Van de Bor M, Briet E, Van Bel F, Ruys J H
Am J Dis Child. 1986 Nov;140(11):1131-4. doi: 10.1001/archpedi.1986.02140250057036.
In a prospective study we analyzed the role of coagulopathy in the development of periventricular-intraventricular hemorrhage (PIVH) in 49 consecutively admitted preterm infants of less than 34 weeks' gestation by serial ultrasound examinations and coagulation assays. In 20 patients (41%) PIVH was detected. On the day of birth, patients with PIVH had significantly lower levels of factor V than did the patients without PIVH, but all other clotting factors gave similar results, and on the third and fifth days all results were similar, including those for factor V. Even the small subgroup of infants who subsequently developed grade IV hemorrhage did not have a more severe coagulopathy than the other infants, although they had significantly lower levels of platelets and of factor VII at birth. We conclude that coagulopathy does not play an important role in the etiology of PIVH. Standard doses of 10 mL/kg of fresh-frozen plasma, administered to increase the low levels of clotting factors, did not prevent extension of the hemorrhage.
在一项前瞻性研究中，我们通过系列超声检查和凝血测定，分析了49例连续入院的孕周小于34周的早产婴儿中凝血病在脑室周围-脑室内出血（PIVH）发生过程中的作用。20例患者（41%）检测到PIVH。出生当天，发生PIVH的患者的因子V水平显著低于未发生PIVH的患者，但所有其他凝血因子结果相似，在第三天和第五天，所有结果包括因子V的结果均相似。即使是随后发生IV级出血的婴儿小亚组，其凝血病也并不比其他婴儿更严重，尽管他们出生时血小板和因子VII水平显著较低。我们得出结论，凝血病在PIVH的病因中不发挥重要作用。给予标准剂量10 mL/kg的新鲜冰冻血浆以提高低水平的凝血因子，并未防止出血的扩展。
