Study On The Correlation Between The Changes Of Platelet Indices And Spontaneous Closure Of PDA

Objective:To analyze the changes of platelet indices in the process of arterial closure,and to explore the relationship between platelet indices and spontaneous closure of PDA in preterm infants.To provide theoretical basis for the treatment of PDA in preterm infants.Methods:A total of 45 preterm infants(gestational age ≤32 weeks or birth weight≤1500g)who were diagnosed as PDA by echocardiography at the 3-5 day after birth and were not treated with nonsteroidal anti-inflammatory drugs,between January 2018 and December 2019 were selected as the case group(PDA group).Based on the matched case-control principle,45 premature infants without PDA were selected as the control group(non-PDA group)according to the proportion of 1:1 among the premature infants hospitalized in the same period and matched with birth weight and gestational age.The differences of platelet indices in 24 hours after birth were compared between the two groups.The PDA group was divided into PDA spontaneous closure at the 2nd week group and PDA non-closure at the 2nd week group according to the results of echocardiography at the 2nd week.The differences of platelet indices were compared between the two groups and control group in the second week after birth.Then the PDA non-closure at the2 nd week group was divided into PDA spontaneous closure at the 3rd week group and PDA non-closure at the 3rd week group according to the results of echocardiography at the 3rd week,and compared the differences of platelet indices between the two group and control group.The spontaneous closure of PDA in the 4th week was set as the PDA spontaneous closure at the 4th week group.The preterm infants whose PDA was not closed at the time of discharge were assigned to the PDA finally unclosed group,and compared the differences of platelet indices between PDA finally unclosed group,PDA spontaneous closure at the 4th week group and control group.The preterm infants whose PDA was closed before the time of discharge were assigned to the PDA finally closed group,and compared the differences of platelet indices between PDA finally unclosed group,PDA finally spontaneous closed group and control group.Results:1.The level of PDW of the PDA group was significantly higher than non-PDA group(10.7±2.3 vs.9.8±1.2)within 24 hours after birth(t=2.251,p=0.027).The other platelet indices including RPR,PLT,PDW,MPV and PCT had no significant difference between the PDA group and non-PDA group(t=0.638、1.020、0.782、-0.482,respectively,p >0.05).2.The platelet indices including RPR,PLT,PDW,MPV and PCT had no significant difference between the PDA spontaneously closed at 2nd week group,the PDA nonclosed at 2nd week group and control group(F=0.859、0.829、0.019、0.745、0.277,respectively,p>0.05).3.The level of PDW in the PDA non-closure at 3rd week group was significantly higher than that in the PDA spontaneous closure at week 3 group and control group at 3rd week after birth(t=-2.287、3.452,p=0.034、0.001,respectively),but there was no difference on PDW between the PDA spontaneous closure at week 3 group and control group(t=-0.149,p=0.882).The other platelet indices including RPR,PLT,MPV and PCT had no significant difference between the three group(F=0.135、0.119、2.536、0.253,respectively,p>0.05).4.The PDW of PDA finally unclosed group was significantly higher than that in the PDA spontaneous closure at week 4 group and control group in the 4th week(t =-2.796、2.039,p= 0.024、0.048,respectively),but there was no difference on PDW between the PDA spontaneous closure at week 4 group and control group(t=-1.141,p=0.262).There was no significant difference in RPR,PLT,MPV and PCT between the three groups(t = 0.259、0.448、0.085、2.824,respectively,p> 0.05).5.The platelet indices including RPR,PLT,PDW,MPV and PCT had no significant difference between the the PDA finally unclosed group,PDA finally spontaneously closed group and control group(F=0.966、0.276、1.932、0.148、0.397,respectively,p>0.05).Conclusion:1.Among platelet indices,PDW were closely related to PDA closure in preterm infants.(1)The higher PDW is associated with PDA in preterm infants within 24 hours after birth.(2)The continuous increase of PDW may indicate that PDA is still opened.2.Other platelet indices,including RPR,PLT,MPV,and PCT,were not significantly associated with spontaneous closure of PDA in preterm infants.