Significance of immature platelet fraction and CD41-positive cells at birth in early onset neonatal thrombocytopenia
Significance of immature platelet fraction and CD41-positive cells at birth in early onset neonatal thrombocytopenia
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出生时未成熟血小板分数和CD41阳性细胞在早发性新生儿血小板减少症中的意义
DOI：
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发表时间：
2010
影响因子：
2.1
通讯作者：
Masao Kobayashi
中科院分区：
文献类型：
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作者：
H. Kihara;Norioki Ohno;Syuhei Karakawa;Yoko Mizoguchi;R. Fukuhara;M. Hayashidani;S. Nomura;K. Nakamura;Masao Kobayashi
早期血小板减少症是患病新生儿常见的血液学异常。在这里，我们检查了新生儿早期血小板减少症与血小板生成相关参数之间的关系，以确定出生时的预测因素。新生儿重症监护病房收治的 244 名新生儿根据血小板计数分为血小板减少症组（n = 55，23%）和非血小板减少症组（n = 189，77%），并在出生 72 小时内进行监测。在放血后不久，用自动血液分析仪同时测定未成熟血小板分数（IPF）和出生时血小板计数。出生时通过流式细胞术检查外周血中 CD41 阳性的巨核细胞及其前体。与非血小板减少组相比，血小板减少组的 IPF 百分比显着升高，CD41+ 单核细胞 (MNC) 百分比显着降低 (P < 0.01)。此外，CD41+ MNC 的百分比将出生时血小板计数 >150 × 103/μL 且临床过程中血小板计数最低值 <150 × 103/μL 的新生儿与无血小板减少症的新生儿显着区分开来。这些观察结果表明，出生时 CD41+ MNC 的百分比和 IPF 百分比是大多数患病新生儿早期血小板减少症的有用预测因子。
Early thrombocytopenia is a common hematological abnormality in sick neonates. Here, we examined the relationship between early thrombocytopenia in neonates and parameters associated with thrombopoiesis to identify predictive factors at birth. Two hundred and forty-four neonates admitted to the neonatal intensive care unit were divided into thrombocytopenic (n = 55, 23%) and non-thrombocytopenic (n = 189, 77%) groups based on platelet counts, which were monitored within 72 h of birth. Immature platelet fraction (IPF) and platelet count at birth were determined simultaneously soon after phlebotomy with an automated hematology analyzer. Megakaryocytes and their precursors positive for CD41 in peripheral blood were examined at birth by flow cytometry. The thrombocytopenic group showed significantly higher IPF percentage and lower percentage of CD41+ mononuclear cells (MNCs) than did the non-thrombocytopenic group (P < 0.01). Moreover, the percentage of CD41+ MNCs significantly differentiated neonates with platelet counts >150 × 103/μL at birth and nadir platelet count <150 × 103/μL over the clinical course from neonates without thrombocytopenia. These observations suggest that the percentage of CD41+ MNCs at birth and IPF percentage are useful predictors of early thrombocytopenia in the majority of sick neonates.