不同胎龄早产儿生后24 h内血小板及相关参数参考范围

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。

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

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.