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不同胎龄新生儿呼吸窘迫综合征早产儿血细胞分析指标及临床特点

Indexes of blood cells analysis and clinical characteristics in premature infants with neonatal respiratory distress syndrome at different gestational ages

    摘要
  • 摘要:
      目的  探讨不同胎龄新生儿呼吸窘迫综合征(NRDS)早产儿母婴血细胞分析指标及临床特点。
      方法  选取本院2019年1月—2020年6月收治的128例NRDS早产儿，根据胎龄分为极早早产儿组56例、中期早产儿组32例、晚期早产儿组40例。回顾性分析3组的母婴血细胞分析指标、围生期高危因素、临床特征、并发症、转归情况。
      结果  极早早产儿组中性粒细胞计数、中性粒细胞百分比低于晚期早产儿组，淋巴细胞百分比高于晚期早产儿组，差异有统计学意义(P < 0.05)。极早早产儿组孕妇白细胞计数、中性粒细胞计数、中性粒细胞百分比高于中期早产儿、晚期早产儿组，淋巴细胞百分比低于其他2组，差异有统计学意义(P < 0.05)。极早早产儿组产前应用糖皮质激素比率与中期早产儿组、晚期早产儿组比较，差异有统计学意义(P < 0.05)。极早早产儿组氧疗时间、住院时间及并发症发生率长于、高于中期早产儿组、晚期早产儿组，而好转出院率低于其他2组，差异有统计学意义(P < 0.05)。
      结论  NRDS早产儿胎龄越小，表现为孕妇白细胞计数越高，围生期高危因素发生率越高，氧疗时间越长，并发症越多，住院时间越长。因此，临床诊治NRDS时应充分考虑胎龄因素，以改善早产儿的预后。

     

    Abstract:
      Objective  To explore the indexes of blood cells analysis and clinical characteristics in premature infants with neonatal respiratory distress syndrome (NRDS) at different gestational ages.
      Methods  A total of 128 premature infants with NRDS from January 2019 to June 2020 were selected and divided into extremely early premature infants group (n=56), medium-term premature infants group (n=32) and advanced premature infants group (n=40) according to gestational age. The indexes of blood cells analysis in mothers and infants, perinatal risk factors, clinical characteristics, complications and outcomes were analyzed retrospectively among the three groups.
      Results  The neutrophil count and percentage of neutrophils in the extremely early premature infants group were significantly lower than those in the advanced premature infants group, while the percentage of lymphocytes in the extremely early premature infants group was significantly higher than that in the advanced premature infants group (P < 0.05). The white blood cell count, neutrophil count and percentage of neutrophils in the extremely early premature infants group were significantly higher than those in the medium-term premature infants group and the advanced premature infants group, while the percentage of lymphocytes in the extremely early premature infants group was significantly lower than that in the other two groups (P < 0.05). There was a significant difference in the ratio of prenatal glucocorticoid use between the extremely early premature infants group and the medium-term premature infants group as well as the advanced premature infants group (P < 0.05). The oxygen therapy time, hospitalization time and incidence rate of complication in the extremely early premature infants group were significantly longer or higher than those in the medium-term premature infants group and the advanced premature infants group, while the discharge rate due to improvement of disease in the extremely early premature infants group was significantly lower than that in the other two groups (P < 0.05).
      Conclusion  When the gestational ages of premature infants with NRDS are relatively smaller, the following situations such as a higher white blood cell count in pregnant women, a higher incidence rate of perinatal risk factors, a longer oxygen therapy time, variety of complications and a longer hospital stay are more likely to happen. Therefore, gestational age should be fully considered in the clinical diagnosis and treatment of NRDS in order to improve the prognosis of premature infants.

     

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