| Background : Periventricular-Intraventricular hemorrhage(PVH-IVH)is a common complication of very low birth weight infants(VLBWI),which is the leading cause of death and neurodevelopmental disorders.It is mainly caused by VLBWI immature germinal stromal area,intraventricular leukoplakia development imperfect and cerebrovascular autonomic disorder.However,whether PVH-IVH and VLBWI coagulation disorders are relevant is not definded,so it is worth further exploration.Study purpose:To study the characteristics of VLBWI in coagulation within 24 hours after birth and to analyze the effect of these indexes and related factors on PVH-IVH and to explore its clinical significance.Patients and methods: This study collected a total of 128 cases of neonates with birth weight less than 1500 g and gestational age less than 32 weeks from December 24,2016 to December 24,2016 who were hospitalized in neonatology at Affiliated Hospital of Qingdao University.The patients were divided into 4 groups according to the birth weight(500-749 g,750-999 g,1000-1249 g and 1250-1499g).According to the gestational age,they were divided into 3 groups(23 + 1-26 w,26 + 1-29 w,29 + 1-32w);all of the newborns within 24 hours after birth to take venous blood clotting routine and blood routine;Ultrasonographic screening of IVH was carried out in all the infants at 3、7 days after birth.30 infants with PVH-IVH(PVH-IVH group)and 98 infants without IVH(control group)were determined for comparison.The risk factors of PVH-IVH were collected during the hospitalization.The association between coagulation values and birth weigh,gestational age evaluated by Spearman’s rank correlation and Pearson correlation coefficient.Chi square test was used to analyze the relationship between clinical value and intracranial hemorrhage.The association between the hemorrhage and coagulation index,PLT by Mann-Whitney U.Results:(1)The gestational age of 128 VLBWI was negative correlated with the plasma APTT(r=-0.28,P<0.05);In addition,the relation of gestational age and PT levels were also negative.(r=-0.31,P<0.05).But there was no correlation with the plasma FIB levels(r=0.06,P>0.05)(2)The birth weight correlaed with the plasma APTT levels was negative(ρ=-0.45,P<0.05);The birth weight correlaed with the plasma PT levels was negative(ρ=-0.23,P<0.05);The birth weight correlaed with the plasma FIB levels was positive(ρ=0.25,P<0.05);But there was no correlation with the plasma DD levels(ρ=-0.14,P>0.05),The coagulation parameters were dependent on birth weight.(3)PVH-IVH group was compared with control group,PVH-IVH group was associated with PLT count,BW,gestational age,low Apgar scores < 5min,premature rupture of membrane,intrauteral embarrassment,The was no correlation with APTT,PT and FIB.Conclusions:(1)There is a relationship between coagulation function of VLBWI and their weight,gestational age.In general,the lower birth weight infant,the lower gestational age are more likely to have coagulation dysfunction.(2)This study shows that gestational age,birth weight,premature rupture of membrane,Apgar<5 scores,intrauteral embarrassment were associated with PVH-IVH.(3)However coagulation index was no correlation with PVH-IVH.(4)PLT were the risk factors for PVH-IVH in VLBWI. |
