亚历山大大学医院新生儿病房血小板减少症的患病率及影响因素：一项包含1000例患者的三年期报告

Prevalence and determinants of thrombocytopenia in newborn unit at Alexandria University Hospital: a three-year report including 1000 patients.

作者信息

Farag Marwa Mohamed, Goda Mohamed Hazem, Nazir Hanan Fawzy, Deghedy Ahmed Akram

机构信息

Alexandria University Hospital, Pediatric Department, Alexandria, Egypt.

出版信息

BMC Pediatr. 2024 Dec 10;24(1):805. doi: 10.1186/s12887-024-05170-7.

DOI:10.1186/s12887-024-05170-7

PMID:39658804

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11629486/

Abstract

BACKGROUND

Thrombocytopenia might be the only clinical clue of diseases in neonates. Classification of thrombocytopenia according to severity, onset offset, nadir and duration might help in identification of the etiology.

AIM

This study aims to estimate the prevalence and, identify the determinants and patterns of thrombocytopenia among neonates.

METHOD

An observational retrospective cohort study was conducted and included records of neonates admitted to neonatal intensive care unit of Alexandria University Maternity Hospital. Data were collected using a checklist and analyzed by SPSS version 20.0. Chi square test and independent sample t- test were used to compare different variables between thrombocytopenic and non- thrombocytopenic patients. Logistic regression analysis was carried out in order to identify the independent contribution of various maternal and neonatal variables influencing thrombocytopenia and factors impacting mortality in thrombocytopenic patients.

RESULTS

Four-thousands five hundred neonates, were randomized to have sample of 1011 neonates to be included in the analysis. Patients were divided into thrombocytopenic group (n = 375) and thrombocytopenic group (n = 636). Gestational age and birthweight were significantly lower in thrombocytopenic group with p values < .001 and .03, respectively. Necrotizing enterocolitis, early onset sepsis and late onset sepsis were the main determinants of neonatal thrombocytopenia with OR (95% CL), 2.25 (1.25-3.98), 4.8 (3.249-7.19) and 6.567(4.083-10.562). severe intraventricular hemorrhage, pulmonary hemorrhage and cardiovascular instability were main predictors of death in thrombocytopenic patients with OR (95% CL), 4 (1.9-8.34), 20.9 (6.7 -64.9), and 5.76 (2.1-15.8), respectively.

CONCLUSION

Identification of severity and patterns of thrombocytopenia can help the clinician to recognize the etiology and consequently optimize management of thrombocytopenic neonates.

摘要

背景

血小板减少症可能是新生儿疾病的唯一临床线索。根据严重程度、发病时间、最低点和持续时间对血小板减少症进行分类可能有助于病因的识别。

目的

本研究旨在评估新生儿血小板减少症的患病率，并确定其决定因素和模式。

方法

进行了一项观察性回顾性队列研究，纳入了亚历山大大学妇产医院新生儿重症监护病房收治的新生儿记录。使用检查表收集数据，并通过SPSS 20.0版进行分析。采用卡方检验和独立样本t检验比较血小板减少症患者和非血小板减少症患者之间的不同变量。进行逻辑回归分析，以确定影响血小板减少症的各种母体和新生儿变量的独立作用以及影响血小板减少症患者死亡率的因素。

结果

4500名新生儿被随机抽取，其中1011名新生儿纳入分析。患者分为血小板减少症组（n = 375）和非血小板减少症组（n = 636）。血小板减少症组的胎龄和出生体重显著较低，p值分别<0.001和0.03。坏死性小肠结肠炎、早发型败血症和晚发型败血症是新生儿血小板减少症的主要决定因素，比值比（95%可信区间）分别为2.25（1.25 - 3.98）、4.8（3.249 - 7.19）和6.567（4.083 - 10.562）。重度脑室内出血、肺出血和心血管不稳定是血小板减少症患者死亡的主要预测因素，比值比（95%可信区间）分别为4（1.9 - 8.34）、20.9（6.7 - 64.9）和5.76（2.1 - 15.8）。