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目的 探讨正常新生儿的纤溶活性状态及胎龄、体重、缺氧对纤溶活性的影响 ,并分析新生儿出血的可能原因及风险因素。方法 对不同胎龄、不同出生体重正常新生儿以及出生窒息足月儿的纤溶酶原活性 (P1g)、组织型纤溶酶原激活物活性 (t PA)、纤溶酶原激活物抑制物活性 (PAI)及D 二聚体含量 (D dimer)进行检测。结果 正常足月新生儿P1g为 (2 84± 0 0 6)IU/ml,t PA为 (0 2 4±0 11)IU/ml,PAI为 (0 64± 0 3 7)AU/ml,PAI/t PA比值为 2 6± 2 0 ,D dimer为 (3 7± 4 7)mg/L ,表现出较宽的取值范围。无合并症早产儿P1g活性为 (2 16± 0 5 2 )IU/ml,D dimer含量为 (1 0± 0 7)mg/L ,PAI/t PA比值为 3 9± 2 6;与正常足月儿相比 ,P1g活性和D dimer含量显著降低 (P <0 0 1) ,PAI/t PA比值显著增高 (P <0 0 5 ) ;窒息足月儿与无合并症早产儿相似 ,P1g活性、D dimer含量为 (1 2 0±0 85 )mg/L ;与足月儿相比 ,P1g活性和D dimer含量亦显著降低 ,而PAI/t PA比值显著增高 ,出生后窒息时间与D dimer含量呈显著正相关 (r=0 5 96,P <0 0 1) ;P1g活性、胎龄、出生体重与D dimer含量均呈显著正相关。结论 正常足月儿纤溶活性有较大个体差异 ;纤溶活性的改变和胎龄、出生体重、缺氧密切相关。纤溶活性
Objective To investigate the status of fibrinolytic activity and the effects of gestational age, body weight and hypoxia on fibrinolytic activity in normal neonates. The possible causes and risk factors of neonatal hemorrhage were analyzed. Methods The levels of plasminogen activator (t PA), plasminogen activator inhibitor (pgA) and plasminogen activator inhibitor (gp) were determined in different gestational age, normal newborns with different birth weight and full- Activity (PAI) and D dimer content (D dimer) were detected. RESULTS: The full-term neonatal P1g was (84 ± 0 0 6) IU / ml, t PA was (0 24 ± 0 11) IU / ml and PAI was (0 64 ± 0 3 7) AU / / t PA ratio of 26 ± 20, D dimer of (37 ± 47) mg / L, showing a wide range of values. The P1g activity in premature infants without complications was (2 16 ± 0 5 2) IU / ml, the D dimer content was (10 ± 0 7) mg / L, PAI / t PA was 39 ± 26, P1g activity and D dimer content were significantly lower (P <0.01), PAI / t PA ratio was significantly higher (P <0.05) in asymptomatic children; , And the content of D dimer was (120 ± 0 85) mg / L. Compared with term infants, the activity of P1g and the content of D dimer were significantly decreased, while the PAI / t PA ratio was significantly increased. The postnatal asphyxia time and D dimer (R = 0 5 96, P <0.01). There was a significant positive correlation between P1g activity, gestational age, birth weight and D dimer content. Conclusions Fetal solution activity in full-term infants has larger individual differences. Changes in fibrinolytic activity are closely related to gestational age, birth weight and hypoxia. Fibrinolytic activity