PDF(Pubmed)
Abstract：
Neonatal thrombocytopenia is a common hematological abnormality that occurs in 20–35% of all newborns in the neonatal intensive care unit. Platelet transfusion is the only known treatment; however, it is the critical point to identify neonates who are really at risk of bleeding and benefit from platelet transfusion as it also has various potential harmful effects.
To investigate the prevalence and risk factors of neonatal thrombocytopenia and its relationship to intraventricular hemorrhage in the neonatal intensive care unit and to determine whether the use of platelet mass index-based criteria could reduce the rate of platelet transfusion.
Retrospective cohort study.
This study was conducted in the neonatal intensive care unit of a tertiary university hospital. The medical records of neonates in the neonatal intensive care unit with platelet counts <150×109/L between January 2013 and July 2016 were analyzed.
During the study period, 2,667 patients were admitted to the neonatal intensive care unit, and 395 (14%) had thrombocytopenia during hospitalization. The rate of intraventricular hemorrhage was 7.3%. Multiple logistic regression analysis showed that although lower platelet counts were associated with a higher intraventricular hemorrhage rate, the effects of respiratory distress syndrome, sepsis, and patent ductus arteriosus were more prominent than the degree of thrombocytopenia. Thirty patients (7%) received platelet transfusion, and these patients showed a significantly higher mortality rate than their non-platelet transfusion counterparts (p<0.001). In addition, it was found that the use of platelet mass index-based criteria for platelet transfusion in our patients would reduce the rate of platelet transfusion by 9.5% (2/21).
Neonatal thrombocytopenia is usually mild and often resolves without treatment. As platelet transfusion is associated with an increased mortality rate, its risks and benefits should be weighed carefully. The use of platelet mass index-based criteria may reduce platelet transfusion rates in the neonatal intensive care unit, but additional data from prospective studies are required.
To investigate the prevalence and risk factors of neonatal thrombocytopenia and its relationship to intraventricular hemorrhage in the neonatal intensive care unit and to determine whether the use of platelet mass index-based criteria could reduce the rate of platelet transfusion.
Retrospective cohort study.
This study was conducted in the neonatal intensive care unit of a tertiary university hospital. The medical records of neonates in the neonatal intensive care unit with platelet counts <150×109/L between January 2013 and July 2016 were analyzed.
During the study period, 2,667 patients were admitted to the neonatal intensive care unit, and 395 (14%) had thrombocytopenia during hospitalization. The rate of intraventricular hemorrhage was 7.3%. Multiple logistic regression analysis showed that although lower platelet counts were associated with a higher intraventricular hemorrhage rate, the effects of respiratory distress syndrome, sepsis, and patent ductus arteriosus were more prominent than the degree of thrombocytopenia. Thirty patients (7%) received platelet transfusion, and these patients showed a significantly higher mortality rate than their non-platelet transfusion counterparts (p<0.001). In addition, it was found that the use of platelet mass index-based criteria for platelet transfusion in our patients would reduce the rate of platelet transfusion by 9.5% (2/21).
Neonatal thrombocytopenia is usually mild and often resolves without treatment. As platelet transfusion is associated with an increased mortality rate, its risks and benefits should be weighed carefully. The use of platelet mass index-based criteria may reduce platelet transfusion rates in the neonatal intensive care unit, but additional data from prospective studies are required.
摘要：
新生儿血小板减少症是一种常见的血液学异常，在新生儿重症监护病房的所有新生儿中有20-35％发生。血小板输注是唯一已知的治疗方法；然而，这是关键的一点，以确定谁是真正有出血的风险，并从血小板输注获益，因为它也有各种潜在的有害影响。
探讨新生儿重症监护病房新生儿血小板减少症的患病率、危险因素及其与脑室内出血的关系，确定使用基于血小板质量指数的标准是否能降低血小板输注率。
回顾性队列研究。
这项研究是在一所三级大学医院的新生儿重症监护病房进行的。分析2013年1月至2016年7月新生儿重症监护病房血小板计数<150×109/L新生儿的病历资料。
在研究期间，2667名病人入住新生儿重症监护室,住院期间有395例(14%)出现血小板减少症.脑室内出血发生率为7.3%。多因素logistic回归分析显示,尽管血小板计数较低与脑室内出血率较高相关,呼吸窘迫综合征的影响，脓毒症,动脉导管未闭比血小板减少程度更明显。30例患者（7%）接受血小板输注，这些患者的死亡率明显高于非血小板输注者（p<0.001）。此外,发现在我们的患者中使用基于血小板质量指数的标准进行血小板输注会使血小板输注率降低9.5%(2/21).
新生儿血小板减少症通常是轻度的，通常无需治疗即可消退。由于血小板输注与死亡率增加有关，应仔细权衡其风险和收益。使用基于血小板质量指数的标准可能会降低新生儿重症监护病房的血小板输注率，但需要来自前瞻性研究的额外数据.
探讨新生儿重症监护病房新生儿血小板减少症的患病率、危险因素及其与脑室内出血的关系，确定使用基于血小板质量指数的标准是否能降低血小板输注率。
回顾性队列研究。
这项研究是在一所三级大学医院的新生儿重症监护病房进行的。分析2013年1月至2016年7月新生儿重症监护病房血小板计数<150×109/L新生儿的病历资料。
在研究期间，2667名病人入住新生儿重症监护室,住院期间有395例(14%)出现血小板减少症.脑室内出血发生率为7.3%。多因素logistic回归分析显示,尽管血小板计数较低与脑室内出血率较高相关,呼吸窘迫综合征的影响，脓毒症,动脉导管未闭比血小板减少程度更明显。30例患者（7%）接受血小板输注，这些患者的死亡率明显高于非血小板输注者（p<0.001）。此外,发现在我们的患者中使用基于血小板质量指数的标准进行血小板输注会使血小板输注率降低9.5%(2/21).
新生儿血小板减少症通常是轻度的，通常无需治疗即可消退。由于血小板输注与死亡率增加有关，应仔细权衡其风险和收益。使用基于血小板质量指数的标准可能会降低新生儿重症监护病房的血小板输注率，但需要来自前瞻性研究的额外数据.
