窒息新生儿肾功能损害白细胞计数和血小板参数动态观察

目的探讨新生儿窒息后肾功能损害患儿外周血白细胞计数(WBC)和血小板参数的动态变化及其临床意义。方法将60例窒息后肾功能损害新生儿分为轻度窒息组(49例)和重度窒息组(11例);选择22例正常新生儿作为对照组,用全自动血细胞分析仪测定各组外周血WBC、血小板计数(PLT)、血小板体积(MPV)及血小板分布宽度(PDW),比较各组间WBC、PLT、MPV、PDW与新生儿窒息后肾功能损害的关系。结果出生后24 h内,轻度窒息组WBC较对照组明显降低,差异有统计学意义(P<0.01);3组PLT比较差异无统计学意义(P>0.05);轻度窒息组和重度窒息组较对照组MPV明显降低,PDW明显升高,差异均有统计学意义(P<0.01);重度窒息组PDW较轻度窒息组明显升高,差异有统计学意义(P<0.05)。出生后第7天,轻度窒息组WBC较对照组明显升高,差异有统计学意义(P<0.01);轻度窒息组和重度窒息组较对照组PLT明显升高,MPV明显降低,PDW明显升高,差异均有统计学意义(P<0.05)。结论 WBC和血小板参数的动态观察可作为监测窒息后肾功能损害的预警参数。

The Dynamic Observation of White Blood Cell Counts and Platelet Parameters in Newborns with Kidney Damage after Asphyxia

Objective To investigate the dynamic changes and clinical significance of white blood cell counts and platelet parameters in newborns with kidney damage after asphyxia.Methods 60 neonates with kidney damage after asphyxia were divided into slight asphyxia group(n=49) and severe asphyxia group(n=11).22 normal newborns were selected as control group.The peripheral blood leukocytes(WBC),the platelet parameters(PLT),the platelet volume(MPV) and the platelet distribution width(PDW) were detected by automatic blood cell analyzer in each group respectively.The relation between the results and the kidney damage after asphyxia were compared between the groups.Results Compared with the control group,the WBC of the slight asphyxia group reduced significantly 24 hours after the birth,the difference was statistically significant(P<0.01);while the difference of PLT between the three groups was not statistically significant(P>0.05).Compared with the control group,MPV of the slight asphyxia group and severe asphyxia group reduced significantly,while PDW increased significantly.The differences were statistically significant(P<0.01);PDW of the severe asphyxia group increased significantly than the slight asphyxia group.The difference was statistically significant(P<0.05).7 days after the birth,compared with the control group,WBC of the slight asphyxia group increased significantly,and the difference was statistically significant(P<0.01).Compared with the control group,PLT of the slight asphyxia group and the severe asphyxia group increased significantly,while MPV reduced significantly and PDW increased significantly.The differences were statistically significant(P<0.05).Conclusion The dynamic observation of peripheral blood leukocytes and platelet parameters can be taken as the warning parameters of kidney damage after asphyxia.