| Objective:To explore the relationship between blood cell parameters in early infancy with patent ductus arteriosus(PDA)in preterm infants.Methods:Preterm infants with gestational age 32 week,including 32 weeks,and birth weight less than 1500g and who were admitted to the neonatal intensive care unit within 24 hours after birth from May 1,2020 to January 1,2021 were recruited.Echocardiography was performed on 72 hours after birth,and hematologic analyze were measured within 24 hours after birth and within 24 hours of completion of echocardiography.These infants were divided into PDA group and non-PDA group based on the results of the first echocardiography.According to the diagnostic criteria of symptomatic PDA,the PDA group was classified into the symptomatic PDA group(s PDA)and the non-symptomatic PDA group(ns PDA),and the blood cell parameters were compared among the three groups.The receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of related indicators for s PDA.The PDA group was divided into treatment group and non-treatment group according to whether ibuprofen was used for treatment.Echocardiography was reexamined and blood cell parameters were detected again on the 7th day after birth.The treatment group was divided into success group and failure group and the non-treatment group was divided into spontaneous closure group and continuous opening group according to the results of echocardiography.To analyze the association of blood cell parameters with spontaneous closure of PDA or failed patent ductus arteriosus closure after a primary course of ibuprofen.Statistical analysis was performed using SPSS 22.0.Results:1.The level of NLR of the s PDA group was significantly higher than ns PDA group within 24 hours after birth(z=-3.116,p=0.005).The level of NLR of the s PDA group was significantly higher than ns PDA and n PDA group on 72 hours after birth(z=-2.440、-2.660,p=0.044、0.023).The other blood cell parameters had no significant difference among the three groups(p>0.05).2.Multiple Logistic regression analysis indicated that the increase of the NLR value was a risk factor for s PDA.3.The area under the ROC curve of the NLR within 24 hours after birth for predicting of s PDA in preterm infants was 0.677(95%CI:0.561～0.794),the best prediction cut off values of the NLR on the 1st day was 1.22(sensitivity was 76.0%,specificity was 53.8%,positive predictive value was 31.1%and negative predictive value was 89%).And the area under the ROC curve of the NLR on 72 hours after birth for predicting of s PDA was 0.686(95%CI:0.565～0.808),the best prediction cut off values of NLR was 1.635(sensitivity was 72.0%,specificity was 62.6%,positive predictive value was 33.9%and negative predictive value was 88.9%).4.In the treatment group,there were significant difference only in the PCT before drug intervention between the success group and the failure group(0.28±0.12%vs0.21±0.06%,t=-2.126,p=0.045).The level of PCT in the success group[0.42(0.35～0.56)]%was significantly higher than that in the failure group[0.33(0.26～0.38)]%after drug intervention(z=2.179,p=0.029).And the level of PLT in the success group(388±216)×10~9/L was significantly higher than that in the failure group(252±95)×10~9/L after drug intervention(t=2.160,p=0.042).The other blood cell parameters had no significant difference between the success group group and failure group(p>0.05).5.In the non-treatment group,the level of RDW(15.1±0.8)%of the spontaneous closure group was significantly lower than the continuous opening group(16.8±1.6)%(t=2.937,p=0.015),and the level of PLT(227±68)×10~9/L of the spontaneous closure group was significantly higher than the continuous opening group(174±32)×10~9/L when PDA was diagnosed(t=-2.827,p=0.009).The level of RDW 15.3(14.6～16.1)%in the spontaneous closure group was significantly lower than that in the continuous opening group 16.4(15.8～19.5)%in the 7 days after birth(t=2.537,p=0.011),and the level of PLT(336±105)×10~9/L was significantly higher than continuous opening group(246±57)×10~9/L,(t=2.404,p=0.024).There were no statistically significant difference in other blood cell parameters between the spontaneous closure group and the continuous opening group(p>0.05).Conclusion:1.The increase of NLR in the early postnatal period of preterm infants is related to the occurrence of s PDA,which has a certain predictive value for s PDA,while there were no significant correlations between other blood cell parameters and s PDA in preterm infants.2.The increased of RDW and decreased of PLT at the time of diagnosis of PDA are associated with spontaneous closure failure of PDA.3.The efficacy of a primary course of ibuprofen treatment for PDA is affected by reduced of PCT before drug intervention. |
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