血小板相关指标对超低出生体质量儿动脉导管未闭的早期预测价值

发布时间：2018-12-16 06:44

【摘要】：目的分析血小板相关指标对于超低出生体质量儿(ELBW)动脉导管未闭(PDA)的早期预测价值。方法回顾分析2013年6月至2016年6月收治的79例ELBW患儿,其中无PDA48例(nPDA组),PDA 31例(PDA组);31例PDA患儿中,无血流动力学意义的PDA(nhsPDA组)17例,有血流动力学意义的PDA(hsPDA组)14例。比较nPDA组与PDA组,以及nhsPDA组与hsPDA组的临床特征及血小板相关指标,采用多元logistic回归模型分析各因素对PDA发生的影响。采用ROC曲线分析相关指标对PDA的早期预测价值。结果与nPDA组相比较,PDA组胎龄小,男婴比例高,血小板分布宽度(PDW)小,差异有统计学意义(P均0.05)。多元logistic回归分析提示PDW越低,发生PDA风险越大(OR=1.26,95%CI:1.05~1.52)。ROC曲线分析发现,PDW最佳诊断界值为13.4 GSD,对PDA早期预测灵敏度为67.74%,特异度为68.75%。hsPDA组胎龄小于nhsPDA组,剖宫产比例低于nhsPDA组,差异有统计学意义(P均0.05),hsPDA组与nhsPDA组间血小板相关指标差异无统计学意义(P均0.05)。结论 PDW对ELBW的PDA具有一定的早期预测价值,伴PDW13.4 GSD的ELBW,需高度警惕PDA。
[Abstract]:Objective to analyze the early predictive value of platelet related indexes in (ELBW) patent ductus arteriosus (PDA) in ultra-low birth weight infants. Methods from June 2013 to June 2016, 79 cases of ELBW were retrospectively analyzed, including no PDA48 (31 cases of), PDA in nPDA group (PDA group). Among the 31 cases of PDA, 17 cases were in PDA (nhsPDA group without hemodynamic significance and 14 cases in PDA (hsPDA group with hemodynamic significance. The clinical characteristics and platelet related indexes of nPDA group and PDA group, nhsPDA group and hsPDA group were compared, and the influence of various factors on PDA was analyzed by multivariate logistic regression model. The early prediction value of PDA was analyzed by ROC curve. Results compared with nPDA group, PDA group had smaller gestational age, higher ratio of male infants and smaller platelet distribution width (PDW) (P < 0. 05). Multiple logistic regression analysis showed that the lower the PDW was, the greater the risk of PDA was (OR=1.26,95%CI:1.05~1.52). ROC curve analysis showed that the best diagnostic threshold of PDW was 13.4 GSD, and the sensitivity to early PDA prediction was 67.74. 4%). The specificity of 68.75%.hsPDA group was lower than that of nhsPDA group, and the ratio of cesarean section was lower than that of nhsPDA group (P 0.05). There was no significant difference in platelet related indexes between nhsPDA group and), hsPDA group (P 0.05). Conclusion PDW has early predictive value for PDA of ELBW. ELBW, with PDW13.4 GSD should be on high alert to PDA..
【作者单位】：广东省妇幼保健院;
【分类号】：R722.6

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