足月窒息新生儿早期凝血功能及血小板参数的变化

目的探讨足月窒息新生儿早期凝血功能及血小板参数的变化及意义。方法对28例足月重度窒息新生儿、24例足月轻度窒息新生儿和26例足月正常新生儿在其生后72h内分别测定凝血酶原时间（PT）、活化部分凝血酶时间（APTT）、纤维蛋白原（FB）、凝血酶时间（TT）、D-二聚体（D-D）以及血小板数目（PLT）、平均体积（MPV）、分布宽度（PDW）、大血小板比率（P-LCR）数值的变化。结果重度窒息足月儿分别与对照组及轻度窒息足月儿凝血功能指标及血小板参数比较，差异有显著性（P〈0．01）。轻度窒息足月患儿与对照组比较，PT、APTT、TT、FB及血小板参数均无显著性差异（P〉0．01），D-D升高，有显著性差异（P〈0．01）。结论足月窒息新生儿早期存在凝血功能异常，表现为DIC早期的高凝状态，通过监测各项凝血指标，特别是D—D对窒息新生儿的诊治有一定临床意义。

Study on the changes of the first blood coagulation function and platelet parameter in asphyxiated fullterm newborns

Objective To explore the changes of the first blood coagulation function and platelet parameter in asphyxiated full-term newborns and its clinical significance.Methods We measured the levels of prothrombin time(PT),thrombin time(TT),D-dimer(D-D)and platelet parameter in 28 sever asphyxiated fullterm nesboms,24 moderate asphyxiated full-term newsborns,26 normal full-term newborns.Results Compared with the group of normal full-term newborns and moderate asphyxiated full-term newborns,PT.APTT.FB.TT.D-D and platelet parameter varied significantly(P＜0.01)in the group of severe asphyxiated full-term newborns.In the group of moderate asphyxiated full-term newborns,the plasma levels D-D increased significantly(P＜0.01),but PT.APTT.FB.TT.PLT varied slightly(P＞0.01).Conclusion This study suggest that there are coagulation abnormalities in asphyxiated full-term newborns.Pre-DIC characterized by hyper-coagulation is present.It is useful for the diagnosis and treatment of asphyxiated full-term newsborns to monitor coagulation function and platelet parameters.