摘要
目的 探讨早产儿末梢血白细胞总数及分类、血小板计数的动态变化及其影响因素,了解不同日龄、胎龄、出生体重的早产儿血细胞参考值的变化特点.方法 2011年11月30日至2014年11月30日期间,在西北妇女儿童医院住院的早产儿中,排除感染性疾病、血液系统疾病和免疫性疾病患儿,共纳入2 849例早产儿进行回顾性研究.按生后日龄分为7组,按出生时胎龄分为3组,按出生体重分为3组,按性别分为男性组与女性组.采集手指末梢血,检测白细胞总数及其分类计数、血小板计数.采用单因素方差分析、独立样本t检验、Spearman相关分析进行统计学分析.结果 7组不同日龄早产儿的白细胞总数、中性粒细胞、淋巴细胞、单核细胞、嗜酸性粒细胞、嗜碱性粒细胞和血小板计数比较,差异均有统计学意义（F值分别为172.00、364.90、34.88、14.22、80.82、168.10、86.64,P值均＜0.01）.白细胞总数在生后≤1d时最高[（18.40±6.87）×109/L],日龄＞2～≤5d时明显下降[（10.62±4.68）×109/L],以后渐趋平缓降低,日龄＞14～≤21d及＞ 21～≤30 d时稳定[分别为（10.54±3.09）×109/L和（10.27±3.70）×109/L].血小板计数生后≤1d及＞1～≤2d时无明显变化[分别为（240.56±63.54）×109/L和（240.85±71.47）×109/L],＞2～≤5d时开始增高[（249.21±80.55）×109/L],＞7～≤14d时达最高[（339.11±121.84）×109/L],再呈小幅度降低并趋稳定.中性粒细胞与淋巴细胞计数在日龄＞5～≤7d时交叉倒置.Spearman相关性检验显示,白细胞总数、中性粒细胞、淋巴细胞、单核细胞、嗜酸性粒细胞、嗜碱性粒细胞和血小板计数与早产儿生后日龄均存在相关性（r值分别为-0.46、-0.60、0.18、-0.07、0.33、-0.47和0.29,P值均＜0.01）.随着出生胎龄增加,白细胞总数、中性粒细胞、单核细胞和血小板计数值增高,淋巴细胞和嗜酸性粒细胞计数值降低,差异均有统计学意义�
Objective To investigate the dynamic changes and influencing factors of peripheral blood white blood cells （WBC）, differential counts （DCs） and platelet （PLT） count in preterm infants to understand the changing characteristics of these blood parameters in preterm infants of different postnatal age, gestational age, and birth weight.Methods Totally 2 849 preterm infants admitted to the Department of Neonatology of Northwest Women＆#39;s and Children＆#39;s Hospital from November 30, 2011 to November 30, 2014 were retrospectively analyzed except for those diagnosed with infectious diseases, hematological system diseases, or immunologic diseases.All of the subjects were divided into seven groups based on their postnatal age, three groups based on gestational age and three groups based on birth weight, or male and female groups, respectively.Peripheral blood samples were obtained for determination of WBC, DCs and PLT.Statistical analysis was performed with oneway analysis of variance, t-test and Spearman linear correlation analysis.Results WBC, neutrophil （Ne）, lymphocyte （Ly）, monocyte （Mo）, eosinophil （Eo）, basophil （Ba） and PLT counts were significantly different among the seven groups of preterm babies of different postnatal age （F=172.00, 364.90, 34.88, 14.22, 80.82, 168.10 and 86.64, respectively, all P 〈 0.01）.WBC was found to be at the peak value within one day after birth [（18.40±6.87）× 109/L], followed by remarkable decrease in day 〉 2-≤ 5 [（10.62±4.68）× 109/L], further gradual decrease thereafter, and then being stable in day 〉 14-≤ 21 and 〉 21 ≤≤ 30 [（10.54±3.09）× 109/L and （10.27 ± 3.70） × 109/L, respectively].PLT counts showed no significant change within one day after birth and in day 〉 1-≤ 2 [（240.56± 63.54）× 109/L and （240.85±71.47） × 109/L, respectively], then began to increase in day 〉 2-≤ 5 [（249.21 ±80.55）× 109/L], peaked in day 〉 7-≤ 14 [（339.11 ± 121.84）× 109/L], and decreased gentl
出处
《中华围产医学杂志》
CAS
CSCD
2015年第12期921-926,共6页
Chinese Journal of Perinatal Medicine
