妊娠期高血压疾病母亲所娩新生儿凝血功能变化及临床意义

目的:探讨母亲妊娠期高血压疾病(HDCP)与新生儿凝血功能的关系。方法:选择2014年2月至2017年10月宜宾市第一人民医院新生儿科NICU收治的HDCP母亲分娩的新生儿280例为研究对象。所有新生儿分为A、B、C三组:A组(n=80例)母亲为重度子痫前期、B 组(n=92例)母亲为轻度子痫前期、C 组(n =108 例)母亲为HDCP;根据胎龄将纳入的新生儿分为中期早产儿(n =90 例)、晚期早产儿(n =112 例)和足月儿(n =78 例)。于出生后2 h 内检测纳入新生儿的各项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)、纤维蛋白原降解产物(FDP)、D-二聚体(D-D)、血小板计数 (PLT)]水平,并进行组间比较。应用Spearman 秩相关分析HDCP 孕母分娩的新生儿凝血指标水平与HDCP 严重程度的相关性。结果:A、B、C 组PLT、PT、APTT、FIB、D-D、FDP 水平组间比较差异有统计学意义(P<0.05);不同严重程度HDCP 孕母分娩的中期早产儿、晚期早产儿和足月儿PLT、PT、APTT、FIB、D-D、FDP 水平组间比较差异有统计学意义(P<0.05);经Spearman 秩相关性分析显示,HDCP 孕母分娩的新生儿PT、APTT、D-D、FDP 水平与HDCP 的严重程度呈正相关(P<0.05);HDCP 孕母分娩的新生儿FIB、PLT 水平与HDCP 严重程度呈负相关(P<0.05)。结论:HDCP 孕母分娩的新生儿血液处于低凝和继发性纤溶亢进的状态,母亲HDCP 越严重,新生儿越易出现凝血功能障碍。

Changes and Clinical Significance of Coagulation Function in Neonates Delivered by Mothers with Hypertensive Disorder Complicating Pregnancy

Objective: To probe into the correlation between hypertensive disorder complicating pregnancy (HDCP) mothers and coagulation function in neonates. Methods: Totally 280 neonates delivered by HDCP mothers admitted to the NICU department of neonatology in the First People''s Hospital of Yibin from Feb. 2014 to Oct. 2017 were selected to be divided into group A, B and C. Mothers in group A (n =80) had severe preeclampsia, those in group B (n =92) had mild preeclampsia, and those in group C (n = 108) had HDCP. According to the gestational age, the included neonates were divided into mid-term preterm infants (n =90), late- preterm infants (n =112) and full-term infants (n =78). Detection of various coagulation parameters including prothobin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), fibrinogen degradation products (FDP), D-dimer (DD), platelet count (PLT) levels in neonates within 2 h after birth were compared among the three groups. Spearman rank correlation was used to analyze the correlation between the coagulation function in neonates and the severity of HDCP. Results: There were significant differences in the PLT, PT, APTT, FIB, D-D and FDP levels among group A, B and C (P<0.05). There were significant differences in the PLT, PT, APTT, FIB, D-D and FDP levels among the mid-term preterm infants, late-preterm infants and full-term infants with different severity of HDCP mothers (P<0.05). According to Spearman rank correlation analysis, the PT, APTT, D-D and FDP levels in neonates born from HDCP mothers were positively correlated with the severity of HDCP (P<0.05). The FIB and PLT levels in neonates born from HDCP mothers were negatively correlated with the severity of HDCP (P <0.05). Conclusion: The blood of newborns delivered by HDCP mothers is in a state of hypocoagulability and secondary fibrinolysis. The more severe the mother''s HDCP, the more likely the neonates is to suffer from coagulation disorder.