【摘要】 目的分析早产儿早期凝血功能特点及影响因素。方法选择2018年1月至2020年2月收住于昆明医科大学第一附属医院的315例胎龄在28～34周的早产儿为研究对象,将早产儿分为窒息组(n=76)、妊娠期高血压组(n=71)、胎盘早剥组(n=78)和对照组(n=90);四组新生儿于出生2小时内行凝血功能检测,比较各组凝血酶原时间(PT)、纤维蛋白原(FIB)、纤维蛋白原降解产物(FDP)、D-二聚体(D-D)、活化部分凝血活酶时间(APTT)的差异。结果各组出生体重及胎龄之间差别无统计学意义(均P>0.05);各组FDP、D-D、PT、APTT、FIB水平差别有统计学意义(F值分别为4.792、5.126、6.783、5.658、11.873,均P<0.05),且进一步两两比较后发现,窒息组、妊娠期高血压组、胎盘早剥组的FDP、D-D、PT、APTT水平均显著高于对照组,而FIB水平显著低于对照组(均P<0.05),但窒息组、妊娠期高血压组、胎盘早剥组三组之间差别无统计学意义(均P>0.05)。结论早产儿早期存在血液高凝和纤溶亢进状态,出生时窒息、其母妊娠期高血压、胎盘早剥加重凝血功能障碍。更多还原

【Abstract】 Objective To analyze characteristics and influencing factors of early blood coagulation function of premature infants.Methods 315 premature infants with 28～34 weeks of gestational age who gave birth in The First Affiliated Hospital of Kunming Medical University from January 2018 to February 2020 were selected as the research subjects.The premature infants were divided into four groups:asphyxia group(n=76),hypertensive disorder complicating pregnancy(HDCP) group(n=71),placental abruption group(n=78) and control group(n=90).The blood samples of the newborns in the four groups were taken within 2 h after birth and the blood coagulation functions were detected.Fiibrinogen(FIB),prothrombin time(PT),fibrin degradation product(FDP),D-dimer(D-D) and activated partial thromboplastin time(APTT) of the newborns were compared among the four groups.Results There were no statistical significant differences in birth weight and gestational age among the four groups(both P>0.05).In serum levels of FDP,D-D,PT,APTT and FIB there were significant differences among the four group(F=4.792,5.126,6.783,5.658 and 11.873 respectively,all P<0.05).And after further two-two comparison,it was found that the serum levels of FDP,D-D,PT and APTT of the newborns in the asphyxia group,hypertensive disorder complicating pregnancy group and placental abruption group were all significantly higher than those in the control group,while the serum level of FIB was significantly lower than that in the control group(all P>0.05),however,there were no statistically significant differences among the asphyxia group,hypertensive disorder complicating pregnancy group and placental abruption group in the five indexes(all P>0.05).Conclusion Premature infants present with hypercoagulability and hyperfibrinolysis in early stage of neonatal period.Neonatal asphyxia,mother suffering from hypertensive disorder complicating pregnancy and placental abruption aggravate coagulation dysfuncion of the premature infants.更多还原