PDF(Pubmed)
Abstract：
BACKGROUND: Perinatal hypoxia may result in coagulation dysfunction. Diminished blood flow or oxygen to the fetus/neonate during the perinatal period can cause bone marrow and liver function impairment, leading to thrombocytopenia, impaired synthesis of clotting and fibrinolytic factors, and increased destruction of platelets in the small blood vessels. The goal of the present study was to evaluate the hemostatic status of newborns with perinatal hypoxia via the non-activated thromboelastometry (NATEM) assay in cord blood samples.
METHODS: 134 hypoxic neonates born in our maternity unit over a 1.5-year period were enrolled in this observational cohort study, and 189 healthy neonates served as the control group. Participation in the study was voluntary and parents signed informed consent prior to recruitment. Demographic and clinical data were recorded on admission, and the NATEM method was performed on cord blood samples. The following NATEM values were evaluated: clotting time (CT), alpha angle (α-angle), clot formation time (CFT), clot amplitude at 5 and 10 min. (A5, A10), maximum clot firmness (MCF), clot lysis index at 60 min. after CT (LI60), and maximum clot elasticity (MCE). Statistical analysis was conducted utilizing the SAS for Windows 9.4 software platform.
RESULTS: Neonates with perinatal hypoxia exhibited decreased fibrinolytic potential in comparison to healthy neonates, as indicated by increased LI60, and this difference was statistically significant (LΙ60: 94 (92-96) Vs 93 (91-95), p value = 0.0001). There were no statistically significant differences noted among the remaining NATEM variables.
CONCLUSIONS: Our findings indicate decreased fibrinolytic potential in hypoxic neonates in comparison to healthy neonates, suggesting that NATEM could serve as an effective tool for promptly identifying hemostasis dysfunction in this group of neonates.
METHODS: 134 hypoxic neonates born in our maternity unit over a 1.5-year period were enrolled in this observational cohort study, and 189 healthy neonates served as the control group. Participation in the study was voluntary and parents signed informed consent prior to recruitment. Demographic and clinical data were recorded on admission, and the NATEM method was performed on cord blood samples. The following NATEM values were evaluated: clotting time (CT), alpha angle (α-angle), clot formation time (CFT), clot amplitude at 5 and 10 min. (A5, A10), maximum clot firmness (MCF), clot lysis index at 60 min. after CT (LI60), and maximum clot elasticity (MCE). Statistical analysis was conducted utilizing the SAS for Windows 9.4 software platform.
RESULTS: Neonates with perinatal hypoxia exhibited decreased fibrinolytic potential in comparison to healthy neonates, as indicated by increased LI60, and this difference was statistically significant (LΙ60: 94 (92-96) Vs 93 (91-95), p value = 0.0001). There were no statistically significant differences noted among the remaining NATEM variables.
CONCLUSIONS: Our findings indicate decreased fibrinolytic potential in hypoxic neonates in comparison to healthy neonates, suggesting that NATEM could serve as an effective tool for promptly identifying hemostasis dysfunction in this group of neonates.
摘要：
背景：围产期缺氧可能导致凝血功能障碍。围产期胎儿/新生儿的血流量或氧气减少会导致骨髓和肝功能受损，导致血小板减少症,凝血和纤溶因子合成受损，并增加小血管中血小板的破坏。本研究的目的是通过脐带血样本中的非活化血栓弹性测定法（NATEM）评估围产期缺氧新生儿的止血状态。
方法：在本观察性队列研究中纳入了在我们的产科出生1.5年的134例缺氧新生儿，189例健康新生儿作为对照组。参与研究是自愿的，父母在招募前签署了知情同意书。入院时记录人口统计学和临床数据，并对脐带血样本进行NATEM方法。评估了以下NATEM值：凝血时间（CT），α角（α角），凝块形成时间（CFT），凝块振幅在5和10分钟。（A5，A10），最大凝块硬度(MCF),60分钟时的凝块溶解指数。CT（LI60）后，和最大凝块弹性(MCE)。采用SASforWindows9.4软件平台进行统计分析。
结果：与健康新生儿相比，围产期缺氧的新生儿显示纤溶潜能降低，如增加的LI60所示，这种差异具有统计学意义(LI60:94(92-96)vs93(91-95)，p值=0.0001)。其余NATEM变量之间没有统计上的显着差异。
结论：我们的研究结果表明，与健康新生儿相比，低氧新生儿的纤溶潜能降低，这表明NATEM可以作为及时识别这组新生儿止血功能障碍的有效工具。
方法：在本观察性队列研究中纳入了在我们的产科出生1.5年的134例缺氧新生儿，189例健康新生儿作为对照组。参与研究是自愿的，父母在招募前签署了知情同意书。入院时记录人口统计学和临床数据，并对脐带血样本进行NATEM方法。评估了以下NATEM值：凝血时间（CT），α角（α角），凝块形成时间（CFT），凝块振幅在5和10分钟。（A5，A10），最大凝块硬度(MCF),60分钟时的凝块溶解指数。CT（LI60）后，和最大凝块弹性(MCE)。采用SASforWindows9.4软件平台进行统计分析。
结果：与健康新生儿相比，围产期缺氧的新生儿显示纤溶潜能降低，如增加的LI60所示，这种差异具有统计学意义(LI60:94(92-96)vs93(91-95)，p值=0.0001)。其余NATEM变量之间没有统计上的显着差异。
结论：我们的研究结果表明，与健康新生儿相比，低氧新生儿的纤溶潜能降低，这表明NATEM可以作为及时识别这组新生儿止血功能障碍的有效工具。
