新生儿凝血试验参考范围相关的研究进展.docVIP

新生儿凝血试验参考范围相关的研究进展 　　[摘要] 人类凝血系统是一个复杂的动态平衡的系统，这对于维持健康的生活至关重要的。在西方国家，由于凝血系统的波动所致非传染性疾病的发病率和死亡率均较高。现在清楚的是，3～6个月龄的婴儿凝血系统尚未完全成熟，新生儿及儿童生理性凝血与成年人也有所不同，有研究证实了这些差异可能是一种自然的生理性保护机制。临床上，足月儿和早产儿（胎龄30～36周）刚出生时凝血试验使用同一参考范围。超早产儿（尤其是胎龄27周）止凝血方面的数据十分稀缺。尚无完整统一的新生儿生后的凝血试验参考范围，因此大大限制止凝血功能正常与否的判断，以及对实验室凝血检查结果异常是否可以指导临床采取干预措施带来极大的困扰。国内新生儿凝血试验参考范围相关研究几乎空白，该综述目的是总结国外对新生儿凝血系统及新生儿年龄相关性凝血参考范围的认识，同时也对新生儿凝血试验的解读进行了综述。 　　[关键词] 新生儿；凝血试验；参考范围 　　[中图分类号] R446 [文献标识码] A [文章编号] 1674-0742（2017）01（c）-0194-05 　　Related Research Progress of Thrombotest Reference Range in Newborns 　　LIU Zhen， WANG Xiao-ming 　　Department of Paediatrics， Shanghai Fifth Peoples Hospital Affiliated to Fudan University， Shanghai， 200240 China 　　[Abstract] The human coagulation system is a complex， dynamic and balanced system， which is vital to maintaining the healthy life， in western country， the morbidity rate and death rate of non-infectious diseases due to the fluctuates of coagulation system are high， and it is clearly that the coagulation system of infants aged from 3 months to 6 months is not completely mature， and the physical coagulation in newborns and children is different from that of adults， and some researches proves that these differences maybe a natural physical protective mechanism， in clinic， the coagulation test of full-term infant and premature baby（the gestational age was from 30 weeks to 36 weeks） used the same range， the data of hemostasis-coagulation of super preterm infants， which greatly limits the judgment of hemostasis-coagulation function， and the related research of thrombotest reference range in newborns at home is blank， and the purpose of the paper is to summarize the awareness of coagulation system in newborns abroad and related coagulation reference range and elaborates the coagulation test in newborns. 　　[Key words] Newborns； Coagulation test； Reference range 　　新生?耗?血系统与儿童、成人存在明显差异，新生儿人群标准化凝血试验异常很常见[1-4]，而这些异常值和临床表现之间的关系，如血栓形成或出血风险相关性仍不明确，同时存在很多认识误区和困惑[5]。儿科病人生理性凝血与成年人不同。尤其是各种凝血障碍性疾病