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早发型新生儿血小板减少症与极早产儿严重脑室出血相关:一项回顾性队列研究。

Early onset neonatal thrombocytopenia is associated with severe intraventricular hemorrhage in very preterm infants: A retrospective cohort study.

机构信息

Division of Neonatology, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey.

Division of Neonatology, Ankara City Hospital, Department of Pediatrics, Ankara, Turkey.

出版信息

J Neonatal Perinatal Med. 2023;16(4):665-671. doi: 10.3233/NPM-230045.

Abstract

BACKGROUND

The role of platelet function in the development of intraventricular hemorrhage is still a subject of debate. In this study, we aimed to determine whether there is an association between platelet indices in the first week of life and severity of intraventricular hemorrhage in very preterm infants.

MATERIALS AND METHODS

Preterm infants born < 30 weeks of gestation in our hospital were retrospectively evaluated. Platelet parameters, including platelet counts, mean platelet volume, platelet distribution width, and platelet mass were retrieved at two different time points: the initial value on the first day of life and the value closest to the end of the first week of life. The infants were categorized according to the findings of cranial ultrasonography as; no intraventricular hemorrhage, mild or severe intraventricular hemorrhage.

RESULTS

Totally, 1051 infants were evaluated. The mean gestational age and birth weight for the entire cohort were 27.9±1.6 weeks and 1058±247 g, respectively. Infants in the severe intraventricular hemorrhage group had significantly lower gestational age (p < 0.001) and birthweight (p < 0.001) compared to other two groups. Furthermore, there were significant differences in platelet count and platelet mass between the groups at two time intervals. However, logistic regression analysis revealed that only platelet count of < 100×109/L on the first postnatal day was independently associated with the severity of intraventricular hemorrhage.

CONCLUSION

There is an association between platelet count of < 100×109/L on the first postnatal day and severe intraventricular hemorrhage in very preterm infants.

摘要

背景

血小板功能在脑室出血发展中的作用仍存在争议。本研究旨在确定早产儿生命第一周血小板指数与脑室出血严重程度之间是否存在关联。

材料与方法

回顾性评估我院出生胎龄<30 周的早产儿。在两个不同时间点(出生第一天的初始值和生命第一周接近结束时的数值)提取血小板参数,包括血小板计数、平均血小板体积、血小板分布宽度和血小板质量。根据头颅超声检查结果将婴儿分为无脑室出血、轻度脑室出血或重度脑室出血。

结果

共评估了 1051 名婴儿。整个队列的平均胎龄和出生体重分别为 27.9±1.6 周和 1058±247g。与其他两组相比,重度脑室出血组的婴儿胎龄(p<0.001)和出生体重(p<0.001)明显更低。此外,两组在两个时间间隔的血小板计数和血小板质量均存在显著差异。然而,逻辑回归分析显示,只有出生后第一天血小板计数<100×109/L 与脑室出血的严重程度独立相关。

结论

在极低出生体重儿中,出生后第一天血小板计数<100×109/L 与重度脑室出血有关。

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