基于生后早期凝血指标和血小板计数的小于32周早产儿颅内出血风险评估

doi:10.3969/j.issn.1006-5725.2026.06.019

Abstract

Abstract:

Objective To analyze the correlation between intracranial hemorrhage and coagulation function， platelet count in preterm infants younger than 32 weeks. Methods A total of 101 preterm infants under 32 weeks who were admitted to Fuyang People's Hospital Affiliated to Anhui Medical University from May 2020 to July 2024 were selected. Within 3 days after birth， all the children were divided into the non-occurrence group （59 cases） and the occurrence group （42 cases） based on whether intracranial hemorrhage occurred in preterm infants less than 32 weeks.The influencing factors of intracranial hemorrhage in preterm infants less than 32 weeks was analyzed. he predictive value of coagulation function index and platelet count for intracranial hemorrhage in preterm infants less than 32 weeks was analyzed. Results The birth weight and gestational age of the occurrence group were lower than non-occurrence group （P < 0.05）.Fibrinogen （FIB） and D-dimer （D-D） in the occurrence group were higher than non-occurrence group （P < 0.05）， and the prothrombin time （PT） and activated partial thromboplastin time （APTT） in the occurrence group were longer than non-occurrence group （P < 0.05）， and platelet count in occurrence group was lower than non-occurrence group （P < 0.05）. FIB （OR = 4.272， 95%CI： 2.154 ? 8.472）， D-D （OR = 3.607， 95%CI： 1.819 ? 7.155）， APTT （OR = 3.056， 95%CI： 1.541 ? 6.060） was an independent risk factor for intracranial hemorrhage in preterm infants less than 32 weeks （P < 0.05）， and platelet count （OR = 0.282， 95%CI： 0.142 ? 0.560） was a protective factor for intracranial hemorrhage in preterm infants less than 32 weeks （P < 0.05）. The AUC values of FIB， D-D， APTT， platelet count and the combined prediction of intracranial hemorrhage in preterm infants less than 32 weeks were 0.799， 0.803， 0.845， 0.796 and 0.911， respectively （P < 0.05）， and the AUC values of the combined four groups were higher （P < 0.05）. Conclusion FIB， D-D， APTT and platelet count have important value in predicting intracranial hemorrhage in preterm infants less than 32 weeks， and the combined value of the four is higher.

Key words: premature infants, intracranial hemorrhage, coagulation function, platelet count, predictive value

CLC Number:

R722.15⁺1

Lili LI,Na′na PAN,Jing XU. Risk assessment of intracranial hemorrhage in preterm infants younger than 32 weeks based on early postnatal coagulation parameters and platelet counts[J]. The Journal of Practical Medicine, 2026, 42(6): 1057-1062.

Figures/Tables 5

Tab.1

Clinical data of the occurrence group and the non-occurrence group"

临床资料	发生组（n = 42）	非发生组（n = 59）	t/ $χ 2$ 值	P值
性别
男	25（59.52）	32（54.24）	0.279	0.597
女	17（40.48）	27（45.76）	0.279	0.597
出生体质量（x ± s）/kg	1.01 ± 0.23	1.64 ± 0.35	10.196	< 0.001
胎龄（x ± s）/周	26.54 ± 0.38	29.41 ± 0.72	23.578	< 0.001
产妇妊娠期合并症
糖尿病	6（14.29）	11（18.64）	0.333	0.564
高血压	18（42.86）	25（42.37）	0.002	0.961
胎盘早剥	4（9.52）	9（15.25）	0.718	0.397
胎膜早破	18（42.86）	24（40.68）	0.048	0.827
生产方式
顺产	27（64.29）	35（59.32）	0.255	0.614
剖宫产	15（35.71）	24（40.68）	0.255	0.614

Tab.1

Tab.2

Tab.3

Influencing factors of intracranial hemorrhage in preterm infants younger than 32 weeks"

因素	β	SE	Wald $χ 2$	P值	OR	95%CI
FIB	1.452	0.361	16.178	< 0.001	4.272	2.154 ~ 8.472
D-D	1.283	0.419	9.376	0.002	3.607	1.819 ~ 7.155
APTT	1.117	0.508	4.835	0.025	3.056	1.541 ~ 6.060
血小板计数	-1.265	0.372	11.564	< 0.001	0.282	0.142 ~ 0.560
胎龄	-0.210	0.180	1.361	0.244	0.811	0.569 ~ 1.154

Tab.3

Tab.4

Fig.1

References 24

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组别	例数	FIB/（g/L）	PT/s	D-D/（mg/L）	APTT/s	血小板计数（×10⁹·L^-1）
非发生组	59	2.13 ± 0.34	14.02 ± 2.56	0.72 ± 0.14	68.74 ± 4.65	231.05 ± 23.46
发生组	42	2.52 ± 0.41	16.78 ± 3.45	0.98 ± 0.24	79.18 ± 5.83	175.16 ± 19.27
t值		5.213	4.617	6.851	9.999	12.686
P值		< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

指标	最佳截断点	灵敏度/%	95%CI	特异度/%	95%CI	P值	AUC值	95%CI	PPV/%	NPV/%
FIB	2.61 g/L	78.57	0.673 ~ 0.864	84.75	0.721 ~ 0.938	< 0.001	0.799	0.696 ~ 0.878	65.80	83.10
D-D	1.03 mg/L	83.33	0.713 ~ 0.921	72.88	0.624 ~ 0.807	< 0.001	0.803	0.702 ~ 0.882	64.70	84.50
APTT	81.45 s	85.71	0.733 ~ 0.947	83.05	0.711 ~ 0.920	< 0.001	0.845	0.748 ~ 0.912	70.80	87.30
血小板计数	165.43 × 10⁹·L^-1	90.48	0.774 ~ 0.953	72.88	0.624 ~ 0.807	< 0.001	0.796	0.694 ~ 0.873	64.30	83.60
四者联合	-	90.48	0.774 ~ 0.953	93.22	0.798 ~ 0.986	< 0.001	0.911	0.826 ~ 0.964	84.32	90.51

Risk assessment of intracranial hemorrhage in preterm infants younger than 32 weeks based on early postnatal coagulation parameters and platelet counts

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