不同胎龄早产儿生后24 h内血小板及相关参数参考范围

王又平; 冯晋楠; 李振宇; 吕小明; 蒋庆蕾; 武辉

doi:10.7499/j.issn.1008-8830.2001036

PDF(1246 KB)

HTML

中国当代儿科杂志 ›› 2020, Vol. 22 ›› Issue (7) : 696-700. DOI: 10.7499/j.issn.1008-8830.2001036

论著·临床研究

不同胎龄早产儿生后24 h内血小板及相关参数参考范围

王又平, 冯晋楠, 李振宇, 吕小明, 蒋庆蕾, 武辉

作者信息 +

Reference ranges of platelet and related parameters within 24 hours after birth in preterm infants with different gestational ages

WANG You-Ping, FENG Jin-Nan, LI Zhen-Yu, LYU Xiao-Ming, JIANG Qing-Lei, WU Hui

Author information +

文章历史 +

摘要

目的研究不同胎龄早产儿生后24 h内血小板及相关参数参考范围并探讨其临床意义。方法根据纳入标准和排除标准，收集2018年1~12月入住新生儿重症监护室且出生胎龄为23~36⁺⁶周早产儿1 070例的临床资料进行回顾性分析，观察生后24 h内不同胎龄早产儿血小板参数参考范围。结果不同胎龄早产儿血小板计数（PLT）及血小板压积（PCT）水平比较差异无统计学意义（P > 0.05）；晚期早产儿组（34~36⁺⁶周，n=667）血小板平均体积（MPV）及血小板体积分布宽度（PDW）均低于极早早产儿组（23~27⁺⁶周，n=36）和早期早产儿组（28~33⁺⁶周，n=367）（P < 0.05）。不同性别早产儿之间血小板及相关参数比较差异均无统计学意义（P > 0.05）。按照不同胎龄来计算早产儿血小板参数的参考范围，23~36⁺⁶周早产儿PLT参考范围为（92~376）×10⁹/L，PCT参考范围为0.1%~0.394%；23~33⁺⁶周早产儿MPV参考范围为9.208~12.172 fl，PDW参考范围为8.390%~16.407%；34~36⁺⁶周早产儿MPV参考范围为9.190~11.950 fl，PDW参考范围为9.046%~15.116%。结论不同胎龄早产儿生后24 h内MPV及PDW不同，依据胎龄制定早产儿MPV及PDW参考范围更有助于指导临床工作。

Abstract

Objective To study the reference ranges of platelet and related parameters within 24 hours after birth in preterm infants with different gestational ages. Methods According to the inclusion and exclusion criteria, a retrospective analysis was performed for the chart review data of 1 070 preterm infants with a gestational age of 23-36⁺⁶ weeks who were admitted to the neonatal intensive care unit from January to December in 2018. The reference ranges of platelet parameters were calculated for the preterm infants within 24 hours after birth. Results There were no significant differences in platelet count (PLT) and plateletcrit (PCT) among the preterm infants with different gestational ages (P > 0.05). The late preterm infants (34-36⁺⁶ weeks; n=667) had significantly lower mean platelet volume (MPV) and platelet distribution width (PDW) than the extremely preterm infants (23-27⁺⁶ weeks; n=36) and the early preterm infants (28-33⁺⁶ weeks; n=367) (P < 0.05). There were no significant differences in these platelet parameters between the preterm infants with different sexes (P > 0.05). The reference ranges of platelet parameters in preterm infants were calculated based on gestational age. The reference ranges of PLT and PCT were (92-376)×10⁹/L and 0.1%-0.394% respectively, for the preterm infants with a gestational age of 23-36⁺⁶ weeks. The reference ranges of MPV and PDW were 9.208-12.172 fl and 8.390%-16.407% respectively, for the preterm infants with a gestational age of 23-36⁺⁶ weeks; the reference ranges of MPV and PDW were 9.19-11.95 fl and 9.046%-15.116% respectively, for the preterm infants with a gestational age of 34-36⁺⁶ weeks. Conclusions The MPV and PDW of preterm infants with different gestational age are different within 24 hours after birth, and it is more helpful for clinical practice to formulate the reference range of MPV and PDW according to gestational age.

导出引用

王又平, 冯晋楠, 李振宇, 吕小明, 蒋庆蕾, 武辉. 不同胎龄早产儿生后24 h内血小板及相关参数参考范围[J]. 中国当代儿科杂志. 2020, 22(7): 696-700 https://doi.org/10.7499/j.issn.1008-8830.2001036

WANG You-Ping, FENG Jin-Nan, LI Zhen-Yu, LYU Xiao-Ming, JIANG Qing-Lei, WU Hui. Reference ranges of platelet and related parameters within 24 hours after birth in preterm infants with different gestational ages[J]. Chinese Journal of Contemporary Pediatrics. 2020, 22(7): 696-700 https://doi.org/10.7499/j.issn.1008-8830.2001036

参考文献

[1] Huang HS, Chang HH. Platelets in inflammation and immune modulations:functions beyond hemostasis[J]. Arch Immunol Ther Exp (Warsz), 2012, 60(6):443-451.
[2] Katz JN, Kolappa KP, Becker RC. Beyond thrombosis:the versatile platelet in critical illness[J]. Chest, 2011, 139(3):658-668.
[3] Leslie M. Cell biology. Beyond clotting:the powers of platelets[J]. Science, 2010, 328(5978):562-564.
[4] McPherson RJ, Juul S. Patterns of thrombocytosis and thrombocytopenia in hospitalized neonates[J]. J Perinatol, 2005, 25(3):166-172.
[5] Henry E, Walker D, Wiedmeier SE, et al. Hematological abnormalities during the first week of life among neonates with Down syndrome:data from a multihospital healthcare system[J]. Am J Med Genet A, 2007, 143A(1):42-50.
[6] Mantadakis E, Tsalkidis A, Chatzimichael A. Thrombocytosis in childhood[J]. Indian Pediatr, 2008, 45(8):669-677.
[7] Wiedmeier SE, Henry E, Sola-Visner MC, et al. Platelet reference ranges for neonates, defined using data from over 47,000 patients in a multihospital healthcare system[J]. J Perinatol, 2009, 29(2):130-136.
[8] 邵肖梅, 叶鸿瑁, 丘小汕. 实用新生儿学[M]. 第5版. 北京:人民卫生出版社, 2019:57, 1070.
[9] Demirel G, Y?lmaz A, Vatansever B, et al. Is high platelet distribution width in the first hours of life can predict hemodynamically significant patent ductus arteriosus in preterm newborns?[J]. J Matern Fetal Neonatal Med, 2020, 33(12):2049-2053.
[10] Dundar B, Dincgez Cakmak B, Ozgen G, et al. Platelet indices in preterm premature rupture of membranes and their relation with adverse neonatal outcomes[J]. J Obstet Gynaecol Res, 2018, 44(1):67-73.
[11] Shaaban HA, Safwat N. Mean platelet volume in preterm:a predictor of early onset neonatal sepsis[J]. J Matern Fetal Neonatal Med, 2020, 33(2):206-211.
[12] Chen CY, Essien MD, Johnson AJ, et al. Use of mean platelet volume in the assessment of intrauterine infection in newborns with combined thrombocytopenia and leukopenia at birth[J]. J Matern Fetal Neonatal Med, 2019. DOI:10.1080/14767058.2019.1608174. Online ahead of print.
[13] Alicja W, Agnieszka P, Piotr L, et al. Platelet indices in late preterm newborns[J]. J Matern Fetal Neonatal Med, 2017, 30(14):1699-1703.
[14] Chen X, Li H, Qiu X, et al. Neonatal hematological parameters and the risk of moderate-severe bronchopulmonary dysplasia in extremely premature infants[J]. BMC Pediatr, 2019, 19(1):138.
[15] 王鸿利. 广泛开展血小板检测及其临床应用[J]. 中华医学检验杂志, 1996, 19(3):137-138.
[16] Olukman O, Ozdemir R, Karadeniz C, et al. Is there a relationship between platelet parameters and patency of ductus arteriosus in preterm infants?[J]. Blood Coagul Fibrinolysis, 2017, 28(1):8-13.
[17] Van den Hof MC, Nicolaides KH. Platelet count in normal, small, and anemic fetuses[J]. Am J Obstet Gynecol, 1990, 162(3):735-739.
[18] Sitaru AG, Holzhauer S, Speer CP, et al. Neonatal platelets from cord blood and peripheral blood[J]. Platelets, 2005, 16(3-4):203-210.
[19] Pietrucha T, Wojciechowski T, Greger J, et al. Differentiated reactivity of whole blood neonatal platelets to various agonists[J]. Platelets, 2001, 12(2):99-107.
[20] Hézard N, Potron G, Schlegel N, et al. Unexpected persistence of platelet hyporeactivity beyond the neonatal period:a flow cytometric study in neonates, infants and older children[J]. Thromb Haemost, 2003, 90(1):116-123.
[21] Andres O, Schulze H, Speer CP. Platelets in neonates:central mediators in haemostasis, antimicrobial defence and inflammation[J]. Thromb Haemost, 2015, 113(1):3-12.
[22] Saving KL, Jennings DE, Aldag JC, et al. Platelet ultrastructure of high-risk premature infants[J]. Thromb Res, 1994, 73(6):371-384.