The correlation betWeen chorioamnionitis＿induced abnormal placental microvessel and platelet metabolism of preterm infants / 中华实用儿科临床杂志

ABSTRACT

Objective To observe the effect of chorioamnionitis on placental microvessel and platelet metabo-lism in premature and the correlation between them. Methods With clinical randomized controlled trial( RCT),the cases were matched by 1 1 according to gestational ages and divided into 2 groups according to the placental pathology results:chorioamnionitis group and control group,32 cases in each group. Dates were obtained for preterm infants(ges-tational age<37 weeks)admitted to the Department of Neonatology at Guangdong Women and Children Hospital,born between June and December 2016. The platelet parameter[platelet count(PLT),mean platelet volume(MPV),plate-let distribution width( PDW),plateletcrit( PCT)],birth weight,thrombocytopenia,hemorrhage complication,miscro-vascular density(MVD)in placenta,platelet activating factors( CD62p ,CD63 )and thrombopoietin( TPO)in preterm infants were recorded and compared. Results In chorioamnionitis group,the infant birth weight[(1. 90 ± 0. 41)kg vs. (2. 31 ± 0. 62)kg]and the PLT in 72 hours[<24 h(197. 97 ± 63. 43)×109/L vs.(266. 34 ± 69. 92)×109/L;24-72 h(202. 28 ± 29. 70)×109/L vs.(256. 38 ± 69. 96)×109/L]were significantly lower compared with the con-trol group,and the differences were statistically significant( all P <0. 05). The incidence of early thrombocytopenia (37. 50% vs. 9. 38% ),intracranial hemorrhage(40. 62% vs. 15. 63% ),MPV[(8. 73 ± 0. 89)fL vs.(8. 27 ± 0. 64)fL] and PDW[(59. 46 ± 5. 90)% vs.(55. 20 ± 5. 37)% ]in 24 hours were significantly higher in chorioamnionitis group, and the differences were statistically significant(all P<0. 05). The placental MVD in chorioamnionitis group signifi-cantly decreased[(9. 08 ± 1. 35)% vs.(12. 89 ± 1. 36)% ,P<0. 05 ]. The level of CD62p ,CD63 and TPO in umbilical cord blood were significantly higher in chorioamnionitis group[(25. 37 ± 5. 20)% vs.(10. 35 ± 2. 94)% ,(9. 49 ± 1. 58)% vs.(4. 04 ± 1. 21)% ,(271. 08 ± 197. 22)μg/L vs.(141. 87 ± 78. 10)μg/L,all P<0. 05]. The placental MVD was positively associated with PLT( r=0. 74,P<0. 05)and negatively associated with CD62p ,CD63 and TPO among infants with chorioamnionitis(r= -0. 64,-0. 44,-0. 44,all P<0. 05). Conclusions The chorioamnionitis may decrease the MVD in placenta and activate platelet in fetal circulation,damaged placental microvessel may activate platelet further.