标题：不同胎龄早产儿出生第1天凝血功能变化及其与胎龄的相关性

      作者：张秀梅，钟伟    南方科技大学医院检验科，广东 深圳 518000

      卷次： 2022年33卷21期

      【摘要】 目的 观察不同胎龄早产儿出生第 1天凝血功能的变化并探讨其与胎龄的相关性。方法 选择2019年7月至2020年10月在南方科技大学医院出生的150例早产儿作为研究对象。根据早产时的不同胎龄将早产儿分为早期组(胎龄28~31+6周) 45例、中期组(胎龄32~33+6周) 50例、晚期组(胎龄34~36+6周) 55例。另选择同期在上述医院出生的60例足月儿作为对照组。出生后第1天，比较不同胎龄早产儿和对照组足月儿及不同胎龄早产儿产妇与对照组产妇的凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)]的变化，并采用Pearson相关性分析法分析胎龄与上述指标之间的相关性。结果 对照组足月儿出生后第1天的PT、APTT、TT水平分别为(13.07±1.98) s、(43.19±5.99) s、(22.17±4.19) s，明显低于早期组[(16.78±3.12) s、(60.11±5.11) s、(28.98±4.18) s]、中期组[(16.01±2.98) s、(58.65±7.09) s、(27.81±5.09) s]和晚期组 [(15.65±4.09) s、(58.09±6.53) s、(27.58±4.16) s]，而 FIB 水平为 (2.09±0.37) g/L，明显高于早期组的 (1.18±0.21) g/L、中期组的(1.21±0.34) g/L和晚期组的(1.25±0.42) g/L，差异均具有统计学意义(P<0.05)；而早期、中期、晚期早产儿三组出生后第 1天的PT、APTT、FIB、TT比较差异均无统计学意义(P>0.05)；不同胎龄早产儿产妇与对照组产妇凝血功能指标比较差异均无统计学意义(P>0.05)；经 Pearson相关性分析结果显示，PT、APTT、TT水平与胎龄均呈负相关(r=-0.712，-0.639，-0.591，P<0.05)，FIB水平与胎龄呈正相关(r=0.653，P<0.05)。结论 不同胎龄早产儿出生后第1天的凝血功能与足月儿比较有差异，且胎龄与凝血功能密切相关。
      【关键词】 早产儿；胎龄；凝血功能；凝血酶原时间；活化部分凝血活酶时间；纤维蛋白原；凝血酶时间
      【中图分类号】 R722.6 【文献标识码】 A 【文章编号】 1003—6350（2022）21—2792—03

Changes of coagulation function in premature infants of different gestational ages on the first day of life and itscorrelation with gestational age.
ZHANG Xiu-mei, ZHONG Wei. Department of Laboratory, Hospital of SouthernUniversity of Science and Technology, Shenzhen 518000, Guangdong, CHINA
【Abstract】 Objective To observe the changes of coagulation function in premature infants of different gesta-tional ages on the first day of life, and to explore its correlation with gestational age.Methods A total of 150 prematureinfants born in the Hospital of South University of Science and Technology from July 2019 to October 2020 were select-ed as the research objects. According to the different gestational ages at the time of preterm birth, preterm infants were di-vided into early preterm infants group (gestational age 28-31+6 weeks, n=45), medium-term preterm infants group (gesta-tional age 32-33 +6 weeks, n=50), and late preterm infants group (gestational age 34-36+6 weeks, n=55). In addition, 60term infants born in the above-mentioned hospitals in the same period were selected as the control group. The first dayafter birth, the changes of coagulation function indexes [prothrombin time (PT), activated partial thromboplastin time(APTT), fibrinogen (FIB), and thrombin time (TT)] were compaared among preterm infants of different gestational agesand term infants and also among their mothers. The correlation between gestational age and the above indexes was ana-lyzed by Pearson correlation analysis. Results The levels of PT, APTT, and TT on the first day after birth in the controlgroup were (13.07±1.98) s, (43.19±5.99) s, and (22.17±4.19) s, which were significantly lower than (16.78±3.12) s,(60.11±5.11) s, (28.98±4.18) s in early preterm infants group, (16.01±2.98) s, (58.65±7.09) s, (27.81±5.09) s in the medi-um-term preterm infants group, and (15.65±4.09) s, (58.09±6.53) s, and (27.58±4.16) s in the late preterm infants group,while the FIB level was (2.09±0.37) g/L, significnatly higher than (1.18±0.21) g/L in the early preterm infants group,(1.21±0.34) g/L in the medium-term preterm infants group, and (1.25±0.42) g/L in the late preterm infants group (P<0.05).There was no significant difference in PT, APTT, FIB, and TT on the first day after birth among the early preterm infantsgroup, medium-term preterm infants group, and late preterm infants group (P>0.05). There was no significant difference inthecoagulation function indexes between preterm infants of different gestational ages and term infants in the controlgroup (P>0.05). The results of correlation analysis showed that the levels of PT, APTT, and TT were negatively correlat-ed with gestational age (r=-0.712, -0.639, -0.591, P<0.05), and the level of FIB was positively correlated with gestationalage (r=0.653, P<0.05). Conclusion The coagulation function of premature infants of different gestational ages on thefirst day after birth is different from that of term infants, and gestational age is closely related to coagulation function.
      【Key words】 Preterm infants; Gestational age; Coagulation function; Prothrombin time; Activated partial throm-boplastin time; Fibrinogen; Thrombin time