Peters M, Ten Cate J W, Breederveld C, De Leeuw R, Emeis J, Koppe J
Pediatr Res. 1984 Mar;18(3):273-6. doi: 10.1203/00006450-198403000-00012.
Automated microanalytic chromogenic coagulation assays allow serial monitoring of critically ill newborn infants. In this study 84 premature infants [26 healthy prematures and 58 neonates with idiopathic respiratory distress syndrome (IRDS)] were studied daily during the first week of life, to investigate the possible significance of hemostatic abnormalities in IRDS. In neonates with IRDS, coagulation factors II and X, antithrombin III (AT-III), plasminogen, and alpha 2-antiplasmin were significantly lower than control values. Recovery of the initially low AT-III levels was delayed relative to the other coagulation parameters measured. An AT-III less than or equal to 0.15 U/ml was present within the first 6 h of life in eight patients who developed IRDS, seven of whom died within 48 h. Autopsy of these neonates showed widespread fibrin deposition and hemorrhage in vital organs consistent with intravascular coagulation. These findings indicate that very low levels of AT-III are associated with disseminated intravascular coagulation in neonates with IRDS and suggest that a deficiency of AT-III is predictive of a poor outcome.
自动化微量分析显色凝血试验可对危重新生儿进行连续监测。在本研究中，对84例早产儿[26例健康早产儿和58例患有特发性呼吸窘迫综合征（IRDS）的新生儿]在出生后第一周每天进行研究，以探讨IRDS中止血异常的可能意义。患有IRDS的新生儿，凝血因子II和X、抗凝血酶III（AT-III）、纤溶酶原和α2-抗纤溶酶显著低于对照值。相对于所测量的其他凝血参数，最初较低的AT-III水平的恢复延迟。8例发生IRDS的患者在出生后6小时内AT-III≤0.15 U/ml，其中7例在48小时内死亡。对这些新生儿的尸检显示重要器官广泛的纤维蛋白沉积和出血，符合血管内凝血。这些发现表明，极低水平的AT-III与患有IRDS的新生儿的弥散性血管内凝血有关，并提示AT-III缺乏可预测不良预后。
