不同胎龄早产儿早期凝血指标的变化及其临床意义

目的:研究不同胎龄早产儿早期凝血指标的变化及其临床意义。方法:选取2012年1月至2017年7月期间我院出生的新生儿392例为研究对象。根据新生儿胎龄的不同分为早期早产儿组(胎龄27~31周)78例、中期早产儿组(胎龄32~33周)102例、晚期早产儿组(胎龄34~36周)116例以及足月新生儿组(胎龄37~42周)96例。四组新生儿出生后2h内抽取静脉血检测凝血指标,包括凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB),并应用Pearson相关性分析分析新生儿胎龄与上述各项凝血指标水平的相关性。结果:早期早产儿组、中期早产儿组、晚期早产儿组、足月新生儿组的出生体重以及胎龄呈逐渐上升趋势,不同组别新生儿的出生体重以及胎龄差异均有统计学意义(P0.05)。早期早产儿组、中期早产儿组、晚期早产儿组、足月新生儿组PT、APTT均呈逐渐下降趋势,FIB呈逐渐上升趋势,不同组别新生儿PT、APTT、FIB差异均有统计学意义(P0.05)。Pearson相关性分析显示,新生儿胎龄与PT、APTT呈负相关(r=-0.567、-0.691,P=0.000、0.000),而新生儿胎龄与FIB水平呈正相关(r=0.623,P=0.000)。结论:不同胎龄早产儿早期凝血功能存在异常变化,新生儿胎龄与PT、APTT均呈负相关关系,与FIB呈正相关关系,临床应予以重视,及时检测其凝血指标,必要时应予以干预治疗。

Changes of Early Coagulation Indexes in Preterm Infants with Different Gestational Ages and its Clinical Significance

ABSTRACT Objective: Investigate the changes of early coagulation indexes in preterm infants with different gestational ages and its clinical significance. Methods: 392 newborns who were born in our hospital from January 2012 to July 2017 as the subjects. The new- borns were divided into 78 cases of early preterm infants group (gestational age 27 to 31 weeks), 102 cases of moderate preterm infants group (gestational age 32 to 33 weeks), 116 cases of late preterm infants group (gestational age 34 to 36 weeks) and 96 cases of newborn group (gestational age 37 to 42 weeks). The blood samples of four groups of newborns were taken from 2h after birth, and the blood co- agulation indexes were detected, which was included prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrino- gen (FIB), the correlation between the gestational age and the levels of the above coagulation indexes was analyzed by Pearson correla- tion analysis. Results: The birth weight and gestational age of the early preterm infants group, the moderate preterm infants group, the late preterm infants group and the newborn group showed a gradual upward trend, the birth weight and gestational age of the newborns in dif- ferent groups were statistically significant (P<0.05). PT and APTT of the early preterm infants group,the moderate preterm infants group,the late preterm infants group and the newborn group showed a downward trend, and FIB showed a gradual upward trend, PT, APTT and FIB among the different groups were statistically significant (P<0.05). Pearson correlation analysis showed that the gestational age was negatively correlated with PT and APTT (r=-0.567, -0.691, P=0.000, 0.000), while the gestational age was positively related to the level of FIB (r=0.623, P=0.000). Conclusion: Early coagulation function in premature infants of different gestational age have abnormal changes, the newborn gestational age is negatively correlate with PT and APTT, and positively correlate with FIB, clinical should be pay high attention, the blood coagulation index should be detect in time, and intervention should be done when necessary.