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投稿时间：2020-03-25 网络发布日期：2020-08-20
投稿时间：2020-03-25 网络发布日期：2020-08-20
中文摘要: 目的 探讨早产儿凝血六项联合检测预测颅内出血的预测价值。方法 选取2017年10月至2019年10月收治的早产儿100例作为早产组,根据胎龄分为早期早产组(28周≤胎龄<34周)32例和晚期早产组(34周≤胎龄<37周)68例;选取同期收治的足月新生儿100例作为对照组。检测所有入组新生儿的活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、国际标准化比率(INR)、纤维蛋白原(FIB)、凝血酶时间(TT)、D二聚体(D-D)水平,分析早产儿颅内出血情况,以及早产儿凝血功能对颅内出血的预测价值。结果 早产组血清FIB低于对照组,D-D、PT、TT、APTT、INR均高于对照组(P<0.01)。早期早产儿血清FIB低于晚期早产儿,D-D、PT、TT、APTT、INR均高于晚期早产儿(P<0.05,P<0.01)。早产儿颅内出血率为16.00%,早期早产儿颅内出血率高于晚期早产儿(34.38% vs 7.35%,χ2=11.822,P<0.01)。颅内出血组早产儿的血清FIB低于颅内未出血组,D-D、PT、TT、APTT、INR均高于颅内未出血组(P<0.05)。ROC曲线显示,血清FIB、D-D、PT、TT、APTT、INR联合检测诊断早产儿颅内出血的曲线下面积(AUC=0.892)高于六者单独检测(AUC=0.652~0.746)。结论 早产儿凝血功能下降,胎龄越小影响越大;凝血六项联合检测对早产儿颅内出血有较高预测价值。
Abstract:ObjectiveTo explore the clinical value of six items of blood coagulation in predicting intracranial hemorrhage in premature infants.MethodsA total of 100 premature infants who were admitted to the hospital from October 2017 to October 2019 were enrolled as preterm group.According to different gestational ages,they were divided into early premature group (32 cases,28 weeks ≤ gestational age <34 weeks) and late premature group (68 cases,34 weeks ≤ gestational age <37 weeks).A total of 100 full-term neonates who were admitted in the same period were enrolled as control group.Activated partial thromboplastin time (APTT),prothrombin time (PT),international normalized ratio (INR),fibrinogen (FIB),thromboplastin time (TT) and D dimer (D-D) level of all infants were detected.The intracranial hemorrhage and the predictive value of coagulation function in intracranial hemorrhage were analyzed.ResultsSerum FIB in preterm group was lower,while D-D,PT,TT,APTT and INR were higher than those in control group (P<0.01).The serum FIB in early premature group was lower,while D-D,PT,TT,APTT and INR were higher than those in late premature [JP2]group (P<0.05,P<0.01).The rate of intracranial hemorrhage in preterm infants was 16.00%,and the rate of intracranial hemorrhage in early preterm infants was higher than that in late preterm infants (34.38% vs 7.35%,χ2=11.822,P<0.01).The serum FIB in intracranial hemorrhage group was lower,while D-D,PT,TT,APTT and INR were higher than those in intracranial non-hemorrhage group (P<0.05).The ROC curve showed that the area under the curve (AUC=0.892) of the combined detection of serum FIB,D-D,PT,TT,APTT,and INR in the diagnosis of intracranial hemorrhage in preterm infants was higher than that of the six individual detections(AUC=0.652-0.746).ConclusionsThe coagulation function of premature infants is declined.The younger the gestational age,the greater the influences.The combination of APTT,PT,INR,FIB,TT and D-D is of relatively higher predictive value in intracranial hemorrhage of premature infants.
keywords: Intracranial hemorrhage Activated partial thromboplastin time Fibrinogen Prothrombin time D-dimer Premature infant Prediction
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| Author Name | Affiliation |
| CHEN Zhi,LI Ming,GE Zhong-ling | Department of Neonatology,Eastern District of Anhui Maternal and Child Health Hospital,Hefei,Anhui 230000,China |
引用文本：
陈智,李明,葛中玲.凝血六项联合检测预测早产儿颅内出血临床价值[J].中国临床研究,2020,33(8):1101-1103,1107.
陈智,李明,葛中玲.凝血六项联合检测预测早产儿颅内出血临床价值[J].中国临床研究,2020,33(8):1101-1103,1107.