早产儿脑室内出血(IVH)的部分凝血因子与血小板参数的变化.docxVIP

早产儿脑室内出血（IVH）的部分凝血因子与血小板参数的变化

【摘要】目的早产儿脑室内出血的发生率高，是造成早产儿死亡和残疾的主要原因之一，严重影响存活患儿的生存和生活质量。目前的研究认为早产儿脆弱的血管因素和众多的血管外影响因素是其发病的主要原因。本研究旨在通过检测PT、KPTT、FIB、血小板参数等指标来前瞻性地研究部分凝血因子和血小板对早产儿IVH发生发展的影响作用。方法选择2005年5月—2007年5月在温州医学院附属育英儿童医院新生儿科住院,24h内入住胎龄小于37周且体重小于1500g的早产儿为研究对象。按出生3天内头颅B超检查结果，分为出血组和对照组。所有入选患儿须排除严重的先天性畸形，遗传代谢性疾病和严重的凝血障碍性疾病。所有患儿在入院第2天查血常规入院第4天采血进行凝血三项，对两组的计量资料采用t检验，基因型比例和等位基因频率的组间比较采用四格表χ2检验。结果IVH组PT平均为±，无IVH组为±；IVH组APPT为±，无IVH组为±；IVH组FIB为±/L，无IVH组为±/L。经统计学分析，三项凝血指标在两组间比较差异均有显着性。IVH组血小板计数为±，血小板平均体积为±，血小板比积为±，血小板分布宽度为±；无IVH组分别为±。±，±，±。IVH组血小板计数和血小板比积与无IVH组比较差异有显着性；血小板平均容积和血小板分布宽度在两组间差异无显着性。结论IVH早产儿存在凝血指标的异常，且重度出血较轻度出血更明显。IVH早产儿存在血小板参数的异常。

【关键词】早产儿；脑室内出血；凝血因子；血小板

【Abstract】ObjectiveIntraventricularhaemorrhageisahighincidencediseaseofpreterminfants.Itisthemaincauseforpreterminfantmortalityanddisability,anddamagestheirqualityoflifeseriously.Currently,thevasculareventsareregardedasthemaincausesofIVH,butfewerresearchesfocusoncoagulationprofileandfibrinogensystem.Intermsofthemechanismofhemorrhageandcoagulation,wepostulatedthatthecoagulationdisturbanceofthepreterminfantsalsoplayedakeyroleinIVH.Inthispaper,somecriteriasuchasPT,KPTT,FIBandPLTof143preterminfantswereInfantsbelow37weeksofgestationalageandweightbelow1500gbetweenMay2005andMay2007whowerehospitalizedwithin24hoursofageintheNICUofYuyingChildren’sHospitalofWenzhouMedicalCollagewereincludedinourinvestigation,andtheexcludedcriteriawerediagnosedwithcongenitalmalformation,inbornerrorsofmetabolismandseverecoagulationdisturbance.TheyweredividedintoIVHandcontrolgroupsaccordingtothereportofHUSwithinthreedaysofage,whichwereassessedbyradiologistsindependently.CBCweremenstruatedonthe2nddayofageandPT,APTT,FIBweremenstruatedonthe4thdayofageinthesetotal143pretermThereweresignificantdifferencesbetweenIVHandcontrolgroups