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张红飞, 张玲萍, 毛郑霞, 余欢, 董文斌, 雷小平. 妊娠期高血压对早产新生儿血细胞计数及早发型败血症诊断的影响[J]. 解放军医学院学报, 2021, 42(10): 1025-1029. DOI: 10.3969/j.issn.2095-5227.2021.10.004
引用本文: 张红飞, 张玲萍, 毛郑霞, 余欢, 董文斌, 雷小平. 妊娠期高血压对早产新生儿血细胞计数及早发型败血症诊断的影响[J]. 解放军医学院学报, 2021, 42(10): 1025-1029. DOI: 10.3969/j.issn.2095-5227.2021.10.004
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ZHANG Hongfei, ZHANG Lingping, MAO Zhengxia, YU Huan, DONG Wenbin, LEI Xiaoping. Effects of pregnancy induced hypertension on hemocyte parameters and diagnosis of early-onset sepsis in premature newborns[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2021, 42(10): 1025-1029. DOI: 10.3969/j.issn.2095-5227.2021.10.004
Citation: ZHANG Hongfei, ZHANG Lingping, MAO Zhengxia, YU Huan, DONG Wenbin, LEI Xiaoping. Effects of pregnancy induced hypertension on hemocyte parameters and diagnosis of early-onset sepsis in premature newborns[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2021, 42(10): 1025-1029. DOI: 10.3969/j.issn.2095-5227.2021.10.004
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妊娠期高血压对早产新生儿血细胞计数及早发型败血症诊断的影响

Effects of pregnancy induced hypertension on hemocyte parameters and diagnosis of early-onset sepsis in premature newborns

    摘要
  • 摘要:
      背景   妊娠期高血压(pregnancy induced hypertension，PIH)为非特异性炎症性疾病，导致母体循环白细胞活化及全身炎症反应增强，PIH对子代新生儿早期血细胞影响的研究较少。
      目的  探讨PIH对早产新生儿血细胞计数及早发型败血症(early-onset sepsis，EOS)诊断的影响。
      方法   应用巢式病例对照研究，以我院新生儿科2016年10月1日- 2020年11月30日收治的PIH孕妇分娩的早产儿为观察对象，选择分娩时间在同1个月内、胎龄相差1周内的非PIH孕妇分娩的早产儿为对照，比较两组早产儿生后7 d内血细胞参数及EOS诊断率的差异，并比较两组患儿中临床诊断EOS者单纯因血细胞参数异常而达到EOS临床诊断标准的比例。
      结果   PIH组纳入早产儿104例，非PIH组早产儿104例。PIH组白细胞计数于入院时(8.59 ± 3.89)×109/L vs (11.60 ± 4.97)×109/L、出生后48 h(8.08 ± 3.22)×109/L vs (10.66 ± 4.39)×109/L及出生后7 d(8.77 ± 2.58)×109/L vs (11.55 ± 4.89×109/L均显著低于非PIH组(P均＜0.05)；同时，PIH组血小板计数在入院时(201 ± 60)×109/L vs (253 ± 64)×109/L、出生后48 h(180 ± 73)×109/L vs (257 ± 81)×109/L及出生后7 d(222 ± 92)×109/L vs (313 ± 103)×109/L也均较非PIH组显著降低(P均＜0.05)。两组EOS诊断率无统计学差异(20.19% vs 23.08%，P=0.611)，但在两组临床诊断EOS的患儿中，PIH组单纯因血细胞计数降低而达到EOS临床诊断标准的比例显著高于非PIH组(12/21 vs 2/24，P＜0.001)。
      结论  PIH孕妇所分娩的早产新生儿出生后血细胞参数较非PIH组早产儿低，而血细胞低有可能导致早产儿EOS诊断的扩大化。

     

    Abstract:
      Background   Pregnancy induced hypertension (PIH) is a non-specific inflammatory disease. It can induce the activation of maternal circulating leukocytes, and increase the systemic inflammatory response. However, few studies focus on the changes of the hemocyte parameters of the offspring in early neonatal period.
      Objective   To explore the effects of PIH on the hemocyte parameters and the diagnosis of early-onset sepsis (EOS) in premature newborns.
      Methods   This was a nested case control study. The study subjects were premature infants delivered by PIH pregnant women in our hospital from October 1, 2016 to November 30, 2020. And the control group were premature infants, who were delivered by the non-PIH mothers’ in the same month and the difference of gestational age was within one week. The differences of hemocyte parameters and the incidence of clinical diagnosed EOS between the two groups were compared. In addition, in the infants with clinical diagnosed EOS, the proportion of whom met the EOS diagnostic criteria only due to the abnormal hemocyte parameters was compared between the two groups.
      Results   In the present study,104 paired premature infants were enrolled in the PIH group and the non-PIH group, respectively. Compared to the non-PIH group, the leukocytes decreased (all P＜0.05) in the PIH group at admission (8.59 ± 3.89 × 109/L vs 11.60 ± 4.97 × 109/L), at 48 h after birth (8.08 ± 3.22 × 109/L vs 10.66 ± 4.39 × 109/L) and at 7 days after birth (8.77 ± 2.58 × 109/L vs 11.55 ± 4.89 × 109/L). The platelet level in PIH group was also lower than that in non PIH group (P＜0.05) at admission (201 ± 60 × 109/L vs 253 ± 64 × 109/L), at 48 h after birth (180 ± 73 × 109/L vs 257 ± 81 × 109/L) and at 7 days after birth (222 ± 92 × 109/L vs 313 ± 103 × 109/L). There was no significant difference in the diagnosis rate of EOS between the two groups (20.19% vs 23.08%, P=0.611). However, in the infants with clinical diagnosed EOS, the proportion of infants met the EOS diagnostic criteria only due to the abnormal hemocyte parameters in the PIH group was higher than that in the non-PIH group (12/21 vs 2/24, χ2=12.452, P<0.001).
      Conclusion  The hemocyte parameters of premature newborns of PIH pregnancies are lower than those without exposure to PIH, and this condition may enlarge the diagnosis of EOS in the premature infants of the PIH pregnancies.

     

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