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目的探讨新生儿出生第1天凝血功能指标与危重评分的相关性。方法对2008年12月至2010年4月出生第1天入住本院的足月儿和早产儿进行危重评分,并检测凝血指标,比较患儿凝血指标与疾病严重程度的关系,以及足月儿和早产儿凝血指标在危重评分各组之间的差异。结果出生第1天足月儿抗凝血酶Ⅲ(ATⅢ-)与疾病严重程度负相关,D二-聚体(D-D)与疾病严重程度呈正相关,回归方程=1.715-0.005×ATⅢ-+0.001×D-D,P=0.000;随病情加重,出生第1天足月儿凝血酶原时间(PT)、部分活化凝血活酶时间(APTT)逐渐延长,ATⅢ-水平下降,D-D水平增高,各组间差异有统计学意义(P均<0.05);出生第1天早产儿ATⅢ-水平下降,D-D水平增加,各组间差异有统计学意义(P均<0.05);相同危重程度各组早产儿D-D值较足月儿增高,极危重组更明显[(1278.2±422.6)μg/L比(321.5±105.2)μg/L,P=0.013]。结论 D-D、APTT、ATⅢ-和新生儿疾病的严重程度相关,危重新生儿更易发生凝血功能障碍。
Objective To investigate the correlation between the index of coagulation function and the critical score on the first day of newborn’s birth. Methods The full-term infants and preterm infants admitted to our hospital on the first day of life from December 2008 to April 2010 were scored for severity and the coagulation indexes were measured. The relationship between coagulation index and the severity of the disease was compared with that of full-term infants And coagulation index in preterm children in the critical score differences between groups. Results On day 1 of birth, full-term antithrombin Ⅲ (ATⅢ-) was negatively correlated with severity of disease. D-dimer (DD) was positively correlated with disease severity. Regression equation = 1.715-0.005 × ATⅢ- + 0.001 × DD, P = 0.000. With the aggravation of disease, full-term prethrombotic time (PT), partial activated thromboplastin time (APTT) gradually increased, ATⅢ-level decreased and DD increased (P <0.05). There was a significant difference in ATⅢ-levels and DD levels in preterm infants on the first day of birth (all P <0.05). DD Compared with full-term infants, the values were significantly higher in critically ill patients ([1278.2 ± 422.6] μg / L vs (321.5 ± 105.2) μg / L, P = 0.013]. Conclusions The severity of D-D, APTT, ATⅢ-and neonatal diseases are related to the risk of coagulopathy in critically ill newborns.