解释血小板指数(血小板计数、平均血小板体积和血小板分布宽度)作为新生儿败血症的附加诊断工具

V. Gautam, M. Verma, Abhishek Singh, A. Agarwal, Anupama Verma
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摘要

本研究旨在确定血小板指数(PI)(血小板计数、平均血小板体积[MPV]和血小板分布宽度[PDW])是否可作为新生儿脓毒症(NS)的附加诊断工具。这项观察性横断面研究于2020年4月至2021年4月在印度北方邦密鲁特拉拉·拉杰帕特·拉伊纪念医学院新生儿重症监护病房(NICU)进行。出现败血症样呼吸暂停、腹胀、拒绝进食、进食前吸痰增多、心动过速、体温过低、胸后缩、嗜睡和咕噜声的新生儿;新生儿败血症筛查阳性和/或培养阳性;有脓毒症危险因素的母亲所生的新生儿也被纳入研究。经适当无菌处理后,取静脉血于乙二胺四乙酸(EDTA)小瓶中,送病理实验室进一步分析全血细胞计数(CBC)、绝对中性粒细胞计数(ANC)、白细胞总数(TLC)、c反应蛋白、血小板频率、MPV、PDW。使用SPSS v26.0对数据进行分析。共纳入60名婴儿,其中30名患有脓毒症的新生儿被归类为“病例”组(n = 30), 30名没有脓毒症的新生儿被归类为“对照组”。血小板计数(低)、MPV和PDW(高)是NS的显著预测因子(P < 0.05)。本研究报道,频繁使用的PI (MPV,血小板计数和PDW)是NICU环境中NS发生率的重要预测因子。早产儿和低出生体重儿的PI无明显变化。这些血小板指标可作为低资源环境下检测NS发生率的标志物。
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The interpretation of platelet indices (platelet count, mean platelet volume, and platelet distribution width) as additional diagnostic tool for neonatal sepsis
This study aims to determine whether platelet indices (PI) (platelet count, mean platelet volume [MPV], and platelet distribution width [PDW]) are an additional diagnostic tool for neonatal sepsis (NS). This observational and cross-sectional study was done between April 2020 and April 2021 at the neonatal intensive care unit (NICU) of Lala Lajpat Rai Memorial Medical College Meerut, Uttar Pradesh, India. Neonates with sepsis-like apnea, abdominal distension, refusal of feed, increased pre-feed aspirates, tachycardia, hypothermia, chest retractions, lethargy, and grunting; neonates with sepsis screen positive and/or culture positive; and neonates born to mothers with sepsis risk factors were included in the study. After proper aseptic condition, the venous blood sample was collected in ethylenediaminetetraacetic acid (EDTA) vial and sent to the pathology laboratory for further analysis of complete blood count (CBC) absolute neutrophil count (ANC), total leukocyte count (TLC), C-reactive protein, platelet frequency, MPV, and PDW. The data were analyzed using SPSS v26.0. A total of 60 babies were enrolled, of which 30 neonates with sepsis were categorized as group “cases” (n = 30), and those (n = 30) neonates without sepsis were classified as group “controls.” Platelet count (low), MPV, and PDW (high) were found to be significant predictors of NS (P < 0.05). This study reports that the frequently employed PI (MPV, platelet count, and PDW) are significant predictors of the incidence of NS in NICU settings. There was no significant change in PI in prematurity and low birth weight neonates. These platelet indicators may be used as markers to detect the incidence of NS in low-resource settings.
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