评估新生儿血栓形成风险因素、诊断和治疗的创新方法

Q3 Medicine
A. Makatsariya, A. Vorobev, A. Lazarchuk, S. Einullaeva, N. A. Gomenko, F. A. Magomedova, V. Bitsadze, J. Khizroeva, N. А. Makatsariya, V. B. Zubenko, M. V. Tretyakova, D. Blinov, F. Yagubova, N. Gashimova, K. Grigoreva, M. A. Ponimanskaya, O. Li, A. V. Mostovoi, A. L. Karpova, J.-С. Gris, I. Elalamy
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引用次数: 0

摘要

与其他年龄段的儿童相比,新生儿尤其是重病和早产儿是血栓形成的高危人群。新生儿血栓形成发病率下降的原因可能是新生儿重症治疗的改善和早产儿存活率的提高。新生儿和成人的止血表现出不同的生理特点:凝血因子的浓度、合成率、代谢率、凝血酶和凝血活酶水平不同。同时,新生儿天然血液凝固抑制因子(蛋白 C、蛋白 S、抗凝血酶、肝素辅因子 II)和维生素 K 依赖性凝血因子(FII、FVII、FIX、FX)的阈值很低,而 FVIII 和 von Willebrand 因子的阈值超过成人。因此,新生儿的血浆纤溶活性较低。发生血栓并发症的主要危险因素如下:中心静脉导管、体液容量改变、肝脏疾病以及败血症和炎症过程,尤其是 COVID-19。先天性和后天性孕产妇和新生儿血栓性疾病可能是血栓并发症的另一个危险因素。低分子量肝素是治疗和预防新生儿血栓形成的首选药物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Innovative approaches to assessing risk factors, diagnostics and treatment of neonatal thrombosis
Compared to children of other ages, neonates especially seriously ill and premature subjects comprise a high thrombotic risk group. A decline in the incidence of neonatal thrombosis may be accounted for by improved treatment of severe conditions in newborns and increased survival of premature infants. Neonatal and adult hemostasis exhibit distinct physiological features: difference in concentration, synthesis rate of blood coagulation factors, metabolic rate, thrombin and plasmin levels. At the same time, neonatal threshold values for natural blood coagulation inhibitors (protein C, protein S, antithrombin, heparin cofactor II) and vitamin K-dependent coagulation factors (FII, FVII, FIX, FX) are quite low, whereas that of FVIII and von Willebrand factor exceeds those found in adults. Thus, newborns have lower plasma fibrinolytic activity. The main risk factors for developing thrombotic complications are as follows: central venous catheters, altered body fluid volume, liver disease, as well as sepsis and inflammatory processes particularly COVID-19. The significance of congenital and acquired maternal and neonatal thrombophilia may pose an additional risk factor for thrombotic complications. Low-molecular weight heparins are the first-choice drugs in treatment and prevention of neonatal thrombosis.
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