Effects of hypothermia therapy on coagulopathy in neonates with hypoxic-ischemic encephalopathy of diffe-rent degrees
10.3760/cma.j.issn.2095-428X.2017.12.006
- VernacularTitle:亚低温治疗对不同程度缺氧缺血性脑病新生儿凝血功能的影响
- Author:
Xiaoyan SONG
;
Hongwu CHEN
;
Weihua LIAO
;
Weimin HUANG
- Keywords:
Hypothermia;
Hypoxic-ischemic encephalopathy;
Coagulopathy;
Amplitude integrated electroencephalogram
- From:
Chinese Journal of Applied Clinical Pediatrics
2017;32(12):903-907
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the effects of hypothermia therapy on coagulopathy in neonates with hypoxic-ischemic encephalopathy(HIE) of different degrees.Methods Twenty-five newborns with HIE were divided into 2 groups (moderate HIE group and severe HIE group) by amplitude integrated electroencephalogram(aEEG).The platelet (PLT) count,activated partial thromboplastin time (APTT),prothrombin time(PT),thrombin time(TT),fibrinogen (Fbg) and international normalized ratio (INR) were measured before hypothermia therapy and those after 24 hours,48 hours,72 hours after hypothermia therapy were collected.The hematological parameters of 2 groups were analyzed by repeated measurement analysis of variance.Results The APTT(t=2.239,P<0.05)and PT(t=2.453,P<0.05) of severe HIE group were significantly longer than those of moderate HIE group and significantly different.PLT,PT,APTT and Fbg(all P>0.05)showed no statistically significant difference between 2 groups after hypothermia therapy.The differences in INR(F=12.470,P<0.05),TT(F=8.275,P<0.01)between 2 groups were significant.Fbg at diffe-rent time points showed no significant difference (P>0.05) between 2 groups.The differences in PLT(F=32.420,P<0.01),PT(F=9.377,P<0.01),APTT(F=15.420,P<0.01),TT(F=7.326,P<0.01)and INR(F=12.699,P<0.01)at different time points were significant between 2 groups.The degree of brain injury and time had no interactive effects in PLT,INR and Fbg(all P>0.05).But the degree of brain injury and time had interactive effects in PT(F=3.374,P<0.05),APTT(F=4.227,P<0.05)and TT(F=3.585,P<0.05).It indicated that the change trend in PT,APTT and TT were different between 2 groups.The increase range of PT,APTT and TT of severe HIE group was higher than moderate HIE group after hypothermia therapy for 24 hours.The percentages of severe HIE group who received transfusion with blood product were higher than those of moderate HIE group(P>0.05).Conclusion The coagulopathy function is worse in neonates with severe HIE in hypothermia therapy which may aggravate the hemorrhage risk.And the effect of hypothermia on neonates with moderate HIE is less evident.So hierarchical intervention on coagulopathy in neonates with HIE during hypothermia should be adopted to relieve the hemorrhage risk.
