The relationship between the continuous opening of arterial catheters and platelet parameters in preterm infants / 中华实用儿科临床杂志

ABSTRACT

Objective To analyze the correlation between the continuous opening of patent ductus arteriosus (PDA) in preterm infants and platelet parameters in the first 24 hours of life.Methods The preterm infants (gestational age ＜ 34 weeks) admitted to Neonatal Intensive Care Unit(NICU) of the Affiliated Xuzhou Hospital of Southeast University from November 2012 to July 2018 were enrolled.The following data were collected retrospectivelythe platelet parameters in the first 24 hours of life,clinical factors possibly related to continuous opening of PDA,and echocardiography examination fin-dings on the 4th-7th day after birth.According to the diagnostic criteria of PDA,all preterm infants were divided into symptomatic PDA (sPDA) group,non-sPDA (nsPDA) group,and non-PDA (nPDA) group.SPSS 20.0 software was used for data analysis.Data were analyzed by Chi-square test,LSD or Tambane's T2 of One-Way analysis of variance,and binary Logistic regression analysis of the receiver operating characteristic (ROC) curve.Results Totally 760 preterm infants were chosen,and among them there were 67 cases (8.8％) in sPDA group,106 cases (14.0％) in nsPDA group,and 587 cases (77.2％) in nPDA group.There were significant differences in the terms of gestation age,birth weight,platelet counts (PLT),and plateletcrit (PCT) in the first 24 hours of life among 3 groups (all P ＜ 0.05).The smaller gestation age,the lower birth weight,the lower PLT and PCT in the first 24 hours of life,and the higher incidence of PDA in preterm infants.There were no significant differences in the platelet distribution width,mean platelet volume,and platelet large cell ratio in the first 24 hours of life among 3 groups (all P ＞ 0.05).The low lower birth weight and PCT in the first 24 hours of life were independent risk factors for the occurrence of sPDA in preterm infants (P =0.013,0.000).The risk of occurrence of sPDA in preterm infants will be increased by 3.279-fold (95 ％ CI2.369-4.479) if PCT in the first 24 hours of life is decreased by 0.10％.The area under the ROC curves of PCT and PLT in the first 24 hours of life for prediction of sPDA in preterm infants was 0.757 (95 ％ CI0.712-0.814) and 0.718 (95 ％ CI0.671-0.768),respectively.The best cutoff values of PCT and PLT were 0.178％ (sensitivity was 75.7％,specificity was 71.9％) and 207.5 × 109/L (sensitivity was 71.4％,specificity was 63.2％).Conclusions The continuous opening of PDA in preterm infants may have correlation with the platelet.The low PCT,rather than PLT,in the first 24 hours of life was an independent risk factor and has medium predictive value for the occurrence of sPDA in preterm infants on the 4th-7th day after birth.