不同胎龄早产儿凝血功能指标及其与颅内出血发生风险的关系

doi:10.3969/j.issn.1006-6233.2022.05.024

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Abstract Objective: To investigate the differences in coagulation function among premature infants of different gestational ages, and to analyze the risk factors of intracranial hemorrhage. Methods: The clinical data of 103 premature infants and their mothers hospitalized between January 2018 and January 2021 were retrospectively analyzed. According to gestational age, the infants enrolled were divided into group A (32~33 weeks) and group B (34~36 weeks). Coagulation function indicators were compared between the two groups. The correlation between coagulation function and gestational age, and the risk of intracranial hemorrhage were analyzed. Results: There was no significant difference in gender, age, gestational hypertension, diabetes, cesarean section rate, premature rupture of membranes rate and placental abruption rate between the two groups (P>0.05). The birth weight and gestational age of group A were significantly lower than those of group B (P<0.05). The prothrombin time (PT), activated partial thromboplastin time (APTT) and D-dimer (D-D) levels in group A were significantly longer/higher than those in group B (P<0.05), and fibrinogen (FIB) level was significantly lower than that in group B (P<0.05). Correlation analysis found that APPT (r=-0.247, P<0.05) and PT (r=-0.403, P<0.05) were negatively correlated with gestational age, and FIB was positively correlated with gestational age (r=0.227, P<0.05). D-D (r=-0.178, P>0.05) were not related to gestational age of premature infants. There were 10 cases of intracranial hemorrhage in group A, with an incidence of 23.26%, and 8 cases of intracranial hemorrhage in group B, with an incidence of 13.33%, indicating no significant difference between the two groups (χ²=1.710, P=0.191). Premature infants with and without intracranial hemorrhage were included in the hemorrhage group and the non-hemorrhage group, respectively. There were statistically significant differences in birth weight, gestational age, APTT and FIB between the two groups (P<0.05). Birth weight, APTT and FIB were independent risk factors for intracranial hemorrhage (P<0.05), with variance inflation factor (VIF)<3. Conclusion: APTT, FIB and D-D are significantly different in premature infants of different gestational ages, and APTT and FIB are related to gestational age. Low birth weight, short APTT and high FIB level may increase the risk of intracranial hemorrhage in premature infants.

Key words： Premature infants Intracranial hemorrhage Coagulation function Risk factor

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2022.05.024 OR http://www.hbyxzzs.cn/EN/Y2022/V28/I5/813

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