目的 探讨非侵入性肝纤维化诊断模型对肝细胞癌(HCC)载药微球化疗栓塞(DEB-TACE)术后发生急性肝功能恶化(ALFD)风险的预测及生存分析.方法 回顾性分析288 例经DEB-TACE治疗的HCC患者的临床资料.按照文中标准将患者分为ALFD组与对照组,对比两组患者的基线资料及术前肝功能指标,采用受试者工作特征(ROC)曲线分析术前 Child-Pugh 评分、APRI、FIB-4 对 DEB-TACE 术后 ALFD 的预测价值.利用 Kaplan-Meier对数秩检验及Cox风险回归模型分析生存率,通过多因素Cox比例风险回归模型筛选出独立预后影响因素.结果 除丙氨酸转氨酶水平外,两组间其他肝功能指标差异均有统计学意义(P<0.05).术前Child-Pugh评分、APRI、FIB-4 的曲线下面积分别为0.763、0.735、0.740,均无显著性差异,APRI、FIB-4 最佳截断点值分别为1.42 和4.47.分层分析提示,APRI>1.42 或FIB-4>4.47 是DEB-TACE术后ALFD的危险因素.生存分析表明,APR≤1.42 与APRI>1.42 时的中位生存期分别为32.5 个月、19 个月(P =0.005);FIB-4≤4.47 与FIB-4>4.47 时中位生存期分别为32.5 个月、20.5 个月(P =0.097);多因素Cox风险回归模型分析得到最大肿瘤直径和门静脉侵犯为独立预后影响因素.结论 基于APRI、FIB-4 的非侵入性肝纤维化模型对评估肝细胞癌DEB-TACE术后发生ALFD的风险及生存具有一定的临床应用价值.

患者女,34岁,腰痛 6个月,左小腿疼痛、麻木致跛行 2周,劳累或行走时加重,休息后减轻;既往体健.查体:L3棘突压痛、叩击痛(+),腰部活动受限;左侧直腿抬高试验及俯卧位直腿抬高试验(+).实验室检查未见明显异常.腰椎CT:L3～ 4 椎体水平椎管内(偏左侧)见 53 mm × 61 mm × 64 mm软组织密度病灶,密度欠均匀、边界欠清;骨窗图示L3椎体及附件不规则骨质破坏(图1A );考虑神经源性肿瘤.

Objective: To investigate the abnormal changes of static functional connectivity (sFC) and dynamic functional connectivity (dFC) in the dopaminergic midbrain (ventral dorsal tegmental area and bilateral substantia nigra compacta, VTA/SNc) in patients with first-episode schizophrenia(SCH), and their correlation with the Positive and Negative Symptom Scale (PANSS). Methods: The data of 198 first-episode untreated schizophrenia patients and 199 healthy controls (HC) matched by age, sex and years of education who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2019 to May 2022 were prospectively collected. All subjects underwent high resolution structural MRI and resting state functional magnetic resonance imaging (rs-fMRI) scanning. The dopaminergic midbrain (VTA/SNc) was defined as three regions of interest (ROI). The sFC and dFC analyses with VTA/SNc as seeds were performed to produce a whole-brain diagram initially, which subsequently were compared between schizophrenia group and HC group. Finally, the correlation analysis of sFC and dFC values with the PANSS scores were performed, including the positive scale score, negative scale score, general psychopathology scale score, total score and symptom scores. Results: There were 86 males and 112 females in SCH group, and aged (23±9) years. Meanwhile, there were 95 males and 104 females in HC group, and aged (22±5) years. In the SCH group, the positive (P), the negative (N) and the general psychopathology (G) scale scores and the total score (T) of the PANSS scale was 20±7, 21±7, 41±11 and 82±22, respectively. Compared with the HC group, the VTA showed decreased sFC with four clusters including cerebellar vermis 7/9, left putamen, right thalamus and left middle cingulate gyrus in the schizophrenia group (peak center, t=-4.35, -4.81, -4.35 and -4.65; voxel P<0.005; cluster P<0.05), the right SNc showed decreased sFC with four clusters including left cerebellar hemisphere 4/5/8, right putamen, right medial orbitofrontal gyrus and the left putamen in the schizophrenia group (peak center, t=-4.91, -5.15, -4.77 and -5.21; voxel P<0.005; cluster P<0.05), and the left SNc showed decreased sFC with four clusters including the left putamen, right putamen, right medial orbitofrontal gyrus and left middle cingulate gyrus in the schizophrenia group (peak center, t=-5.82, -4.83 and -4.65; voxel P<0.005; cluster P<0.05). Compared with the HC group, the VTA showed decreased dFC with the right inferior parietal gyrus, right angular gyrus and right superior parietal gyrus in schizophrenia group (t=-4.17). In the schizophrenia group, the sFC value of cluster 2 (left putamen) with VTA as seed and cluster 4 (left putamen) with right SNc as seed were positively correlated with the positive scale scores in PANSS (r=0.141, 0.169, both P<0.05). The sFC and dFC values of significant regions were also correlated with hallucination, delusion, suspicion, hostility, communication disorder, passivity/indifference, lack of communication, stereotyped thinking, depression, non-cooperation, lack of judgment and insight, impulse control disorder, active social avoidance (all P<0.05). Conclusion: The static and dynamic functional connectivity (stability) of VTA/SNc to cerebellum, thalamus, striatum, prefrontal lobe and cingulate gyrus in first-episode schizophrenia patients were decreased, which were closely related to the positive and negative symptoms of schizophrenia.

患者 女,50岁,以"腹痛、腹胀伴发热10 d"为主诉人院.既往无乙肝、丙肝病史.实验室检查:肿瘤标记物CA125106 U/mL,CA199 54.2 U/mL;肝功能分级为 Child A 级.上腹部平扫及增强CT示:肝左叶巨大占位,最大径约157.14 mm×134.54 mm,增强后呈中度强化,肝左静脉及下腔静脉可见充盈缺损(图1).穿刺病理活检示(图2):肝组织内见腺体轻度异型增生,可见腺癌细胞浸润;结合免疫组化,诊断肝内胆管细胞癌(intrahepatic cholangiocarcinoma,ICC);TNM 分期为T3N1M0 Ⅲb 期.

目的:探讨经导管动脉栓塞(TAE)联合微波消融(MWA)治疗肾细胞癌(RCC)的初步疗效、可行性及安全性.方法:回顾性分析2013年9月-2020年4月16例接受TAE联合MWA治疗且资料完整、经病理确诊的RCC患者的临床资料.16例患者首先接受TAE治疗,然后在Dyna CT引导下行MWA.比较治疗前后的实验室指标变化.治疗后1、3、6个月复查增强CT/MRI评价疗效,必要时巩固治疗.观察、记录不良反应及并发症发生情况、生存时间.随访8.9～36.8个月.结果:手术成功率为100％.治疗前后尿常规、肾功能均无显著变化.术后仅出现一过性不良反应,对症治疗后均得到缓解,无严重并发症发生.术后1、3、6个月完全缓解率分别为93.8％(15/16)、93.8％(15/16)、81.2％(13/16),部分缓解率分别为6.2％(1/16)、6.2％(1/16)、18.8％(3/16),客观缓解率均为100％.中位生存期为31.6个月,6、12、18、24个月总生存率分别为100％、92.3％、76.9％、76.9％.结论:TAE联合MWA治疗RCC技术安全可行,可有效控制肿瘤进展,近期疗效肯定.

With the development of detection methods, various biomarkers of liver cancer have been detected constantly, which is of great significance for the early diagnosis and real-time monitoring of liver cancer after treatment. Based on the differences in the sensitivity and specificity of different biomarkers, exploration of the value of diverse biomarkers in the diagnosis and prognosis assessment of liver cancer can provide an important reference for clinicians to scientific and rational application of distinct biomarkers.

目的 探讨载药微球化疗栓塞(DEB-TACE)治疗软组织肉瘤的初步疗效及安全性、可行性.方法 回顾性分析2017年4月至2019年4月接受DEB-TACE治疗的12例软组织肉瘤患者(病灶数24个)的临床资料,术前均经病理学确诊.根据介入术后1、3、6和12个月CT/MRI,评价其疗效.记录无进展生存期(PFS)和总生存期(OS).观察有无严重不良事件(AE).结果 12例患者DEB-TACE手术28例次均顺利,有不同程度的术后反应,以疼痛为主(10/12,83.3％),对症治疗后均好转.中位随访时间14.5个月(4～23个月).疗效评价:术后1、3、6和12个月总客观有效率(ORR)分别为75.0％(9/12)、75.0％(9/12)、66.7％(8/12)、58.3％(7/12),6、12个月OS率和PFS率分别为91.7％和66.7％、83.3％和58.3％,中位PFS为11.5个月(3～23个月);术后1、3、6和12个月局部肿瘤的ORR分别为79.2％(19/24)、83.3％(20/24)、78.3％(18/23)、72.7％(16/22),局部肿瘤中位PFS为17.5个月(3～23个月).结论 DEB-TACE治疗软组织肉瘤近期疗效确切,技术安全可行.

Objective:To investigate the preliminary efficacy and safety of drug-eluting beads transarterial chemoembolization (DEB-TACE) for the treatment of liver metastasis of neuroendocrine tumors (NEN-LM).Methods:The clinical data of 27 patients with NEN-LM treated in Interventional Department from March 2019 to January 2020 were analyzed retrospectively, including 20 pancreas of primary site, 3 duodenum, and 4 rectum. All patients were diagnosed by pathology. Twelve patients underwent treatment of DEB-TACE (DEB-TACE group) and 15 patients were treated with Lipiodol (cTACE group). Response of hepatic lesions were assessed according to mRECIST. Objective response rates (ORR) and safety were compared of the two groups. Follow-up period ranged from 9 to 15 months.Results:The ORRs of 1, 3, 6 and 12 months were 91.7%, 83.3%, 58.3% and 54.5% respectively in DEB-TACE group, but 86.7%, 66.7%, 40.0% and 14.3% respectively in cTACE group. The ORR of 12 months in DEB-TACE group was significantly higher than that in cTACE group (P = 0.043). The main complication of the two groups was post-embolization syndrome, and there was no significantly difference (P > 0.05). No serious complications occurred.Conclusions:Compared to cTACE, DEB-TACE can effectively reduce tumor burden in patients with NEN-LM, which is safe and well-tolerated.

目的 采用3D动脉自旋标记(arterial spin labeling,ASL)灌注成像评估运动功能恢复较好的慢性期皮层下脑梗死患者的静息态脑血流量(cerebral blood flow,CBF),并分析其与认知功能中执行能力的关系.材料与方法 采用GE Discovery MR 750扫描仪对29例慢性期脑梗死患者及30例健康志愿者行3D动脉自旋标记灌注成像.以SPM8中的GLM(一般线性模型)为参考,把教育年限、年龄、性别当作协变量,把"全脑灰质模板"当作mask,实施独立样本t检验,明确对照组、病例组脑血流量不同的脑区,并对其同执行能力间的联系展开讨论.结果 相较于对照组,患者健侧缘上回(supramarginal gyrus,SMG)与额上回(superior frontal gyrus,SFG)脑血流量皆显著增加(P<0.05).上述2个脑区的CBF值皆于连线测试B的反应时间呈负向相关.结论 运动功能有效恢复的慢性期皮层下脑梗死患者远隔病灶的皮层区CBF仍存在异常,同时此部位CBF的改变同认知功能中的执行能力存在相关性.

This case series aimed to preliminarily evaluate the efficacy and safety of drug-eluting beads transarterial chemoembolization (DEB-TACE) in patients with lung, renal, gastric, and other non-liver cancers.Twenty-four patients who underwent DEB-TACE or DEB-TACE combined with other therapies were reviewed in this case series. Treatment responses were assessed at 1 month after treatment according to the modified Response Evaluation Criteria in Solid Tumors. Overall survival (OS) and adverse events were recorded.In the total patients, the objective response and disease control rate were 79.2% and 87.5%, respectively. And the mean OS in total patients was 14.7 months (95% confidence interval: 9.6-19.9 months). The number of patients who had generalized aches, nausea, vomit, fever, abdominal discomfort, chest discomfort, elevated blood pressure, cough, loss of appetite, and headache in total patients were 7 (29.2%), 11 (45.8%), 6 (25.0%), 2 (8.3%), 3 (12.5%), 3 (12.5%), 1 (4.2%), 1 (4.2%), 1 (4.2%), and 1 (4.2%), respectively. The objective response rates in patients with lung, renal, gastric, and other non-liver cancer were 70.0%, 85.7%, 100.0%, and 80.0%, respectively. In patients with lung, renal, gastric, and other non-liver cancers, the mean values of the OSs were 13.4 months, 12.4 months, 7.6 months, and 20.3 months, respectively. And the most common adverse events in lung cancer patients, renal carcinoma patients, gastric cancer patients, and patients with other non-liver cancers were post-embolization syndrome.DEB-TACE may be an effective and safe therapeutic option in patients with lung, renal, gastric, and other non-liver cancers.

病例资料 患者,女,35 岁,因"伸舌偏斜 4 个月,右侧面部麻木 5 天"入院.患者 4 个月前无明显诱因出现伸舌偏斜,5 天前出现右面部麻木.在当地医院药物治疗,效果不佳.影像学检查:头部 MRI(图 1 ～4)示:鼻咽顶后壁、右侧壁、斜坡区、右侧中颅窝底及右侧鞍旁可见不规则团块状等 T1 稍长 T2 信号,病灶向外侵及至右侧咽旁间隙,与右侧蝶骨及颞骨分界不清,部分包饶右侧颈内动脉岩内段,双侧咽隐窝尚存在.双侧翼内外肌可见条片状压脂高信号影.双侧鄂扁桃体肿大.蝶窦、双侧筛窦粘膜增厚,左侧上颌窦内可见片状长 T2 信号.垂体、视交叉显示可.双侧颈部可见多发结节状抑脂高信号.

嗜酸性粒细胞增多症是指外周血中嗜酸性粒细胞绝对计数＞0.5×109/L.它不是一种独立的疾病,而是由多种原因引起的一种血液学的病理改变.根据嗜酸性粒细胞增多程度分为轻度增高(0.5×109/L～1.50×109/L)、中度增高＞1.50×109/L～5×109/L)和重度增高(＞5×109/L)[1].嗜酸性粒细胞增多症常累及肺部、胃肠道、心脏、血管、肌肉等部位,但以脑炎为主要表现的病例较少.现报道1例嗜酸性粒细胞性脑炎患者,分析其病理及影像学特点.

目的 研究健康成年人脑灰质、白质体积和脑脊液含量随年龄的变化特点.资料与方法 对124例右利手健康成年人(18～70岁)进行MR矢状位三维结构T1WI图像扫描,运用基于体素的形态学分析(VBM)技术获得全脑的灰质体积、白质体积、脑脊液含量.比较不同年龄组(18～30岁、31～40岁、41～50岁、51～60岁、61～70岁)受检者灰质体积的差异,分析脑灰质体积、白质体积及脑脊液含量随年龄的变化特点.结果 脑灰质体积的萎缩分布具有不均匀性及时序性,扣带回、额叶先萎缩,逐渐扩展至双侧颞叶、双侧顶叶、双侧岛叶、双侧楔前叶、左侧小脑半球;全脑灰质体积随年龄呈线性下降,全脑白质体积随年龄呈二次方相关改变模式,脑脊液含量随年龄呈线性下降.18～70岁健康成人灰质体积千分比为(453±22)‰,白质体积千分比为(369±18)‰,脑脊液含量千分比为(178±23)‰.结论 VBM技术能够敏感地测量全脑灰质、白质和脑脊液体积随年龄变化的时间、空间模式,有助于进一步了解大脑退化的规律.

Objective: To explore the relationship between simple numerical function and gray matter volume (GMV) in normal brain aging using the voxel-based morphometry(VBM) approach. Methods: A total of 123 individuals from 18 to 70 years old (63 males,60 females,the average age was (43±14) years, were recruited from right-handed healthy Han Chinese volunteers at the Department of MRI at the First Affiliated Hospital of Zhengzhou University between October 2016 and June 2017. All subjects underwent magnetic resonance sagital three-dimensional imaging scanning, and statistical parameter graph (SPM) 8 software was used for voxel-based morphological analysis to compare the differences in gray matter volume between different age groups.Gray matter volume difference brain regions between different age groups were extracted as regions of interest, and correlation analysis was carried out on the score of simple numerical calculation to find the responsible atrophy brain regions related to the decline of simple digital computing ability. Results: The brain regions with different gray matter volume in different age groups mainly included bilateral frontal gyrus, bilateral anterior cingulate gyrus, bilateral middle cingulate gyrus, bilateral olfactory cortex, bilateral caudate nucleus and bilateral insula. Among them the GMV of bilateral superior frontal gyrus and anterior cingulate gyrus showed the strongest correlation with the simple numerical function. Before removing the effect of age, the correlation between the GMV of the bilateral superior frontal gyrus and medial cingulate gyrus and the corrected count of correct was significant (r=0.403,P=0.000), the correlation between GMV and the percent of correct was also significant (r=0.229,P=0.037).After removing age as a covariate, bilateral superior frontal gyrus and central cingulate gyrus were still positively correlated with the correct number after correction of simple numerical calculation function (r=0.225,P=0.014) and the correct percentage (r=0.245, P=0.007). Conclusion: There is extensive gray matter volume atrophy during the normal brain aging process. The decrease of simple numerical function in normal brain aging may be related to the decrease of frontal and anterior cingulate gray matter volume.

目的 探索运动通路不同位置水平梗死后慢性期脑血流改变模式及其差异性.方法 搜集43例左侧基底节区、17例左侧脑桥梗死患者及62名正常对照者(HC)行3D伪连续动脉自旋标记(3D-pCASL)扫描.采用SPM 8软件对脑血流量(CBF)数据进行基于体素的分析,分析步骤包括空间配准、归一化、空间平滑及统计分析.统计分析采用SPM 8中的一般线性模型,将教育年限、性别、年龄作为协变量,以全脑灰质模板作为mask,进行独立样本t检验,比较患者组与正常对照组之间的CBF变化特点.校正方法基于DPABI软件运用Monte Carlo模拟进行集群水平的多重比较校正.结果 与HC组相比,基底节区健侧壳核CBF增加(P＜0.000,T=10.2),患侧中央后回CBF减低(P ＜0.000,T=15.1);与HC组相比,脑桥健侧额下回CBF增加(P ＜0.000,T=10.7);双侧小脑半球CBF减低(健侧:P ＜0.000,T=14.0;患侧:P ＜0.000,T=12.2);基底节区患侧感觉运动区CBF与四肢(P=0.018,r=0.368)、上肢(P=0.015,r=0.378)运动功能评分呈正相关;脑桥患侧小脑半球CBF与四肢(P=0.010,r=0.642)、上肢(P=0.009,r=0.648)运动功能评分呈正相关.结论 慢性期皮层下运动通路梗死患者功能损伤和重组共存,且不同位置水平梗死继发性脑改变模式不同.

Objective:This study was performed to investigate the changes of resting-state networks of first-episode and treatment-naive patients with obsessive-compulsive disorder(OCD)by using resting-state functional magnetic resonance imaging(RS-fMRI)technology.Methods:A total of 24 patients with OCD and 24 age-sex-handedness-education matched healthy adults were scanned with RS-fMRI.Independent component analysis was employed for the data analysis.Statistical analysis was carried out on isolated components.One-sample t-test was performed to make the mask of networks components.And then two sample t-test was performed to explore the difference between OCD patients and healthy controls in functional networks.The Yale-Brown Obsessive Compulsive Scale(YBOCS),24-item Hamilton Rating Scale for depression(HAMD-24)and Hamilton Anxiety Rating Scale(HAMA)were performed to assess the clinical symptoms.Results:Ten masks of resting-state networks were found in all groups.There was anterior default-mode network(aDMN),posterior default-mode network(pDMN),dorsal attention network(DAN),salience network(SN),left frontoparietal network(LFP),right frontoparietal network(RFP),lateral visual network(lVN),medial visual network(mVN),occipital pole visual network(pVN)and auditory network(AN).It was found that the pDMN functional connectivity(FC)in OCD patients was higher than that of healthy controls in bilateral cuneus(T=3.8222,P<0.05),also the RFP FC increased in the right inferior parietal lobule(T=5.291,P<0.05)and the lVN FC increased in right middle occipital lobule(T=4.614,P<0.05).There was a negative correlation between the activated right parietal lobule and Y-BOCS total score(r=-0.470,P<0.05).Conclusions:Some abnormal resting-state networks in first-episode and treatment-naive OCD patients were found,presenting increased functional connections.Certain cognitive function compensation might occur in those patients.

Objective To explore the influence of the location of the infarction lesion on the resting-state functional connectivity (rsFC) of the motor execution network. Methods A total of 144 patients with infarction of the motor pathway were involved in the study, including 97 patients with capsule stroke (CS) and 47 patients with pontine stroke (PS).50 age-matched healthy subjects were enrolled.After acquiring the structural images and the resting-state functional MRI data of all the subjects by 3.0-Tesla MR scanner, the functional connectivity was calculated in different regions of interest and the differences of the rsFC within the motor execution network among patients with different infarction location were compared. Results Left CS patients exhibited increased rsFC in L_PMd (MNI x, y, z: -22, -13, 57) -R_M1 (MNI x, y, z: 38, -22, 56) (F=3.951, P=0.022), the increased rsFC than healthy controls (P=0.031); Left CS patients exhibited increased rsFC in R_PMv (MNI x, y, z: 53, 0, 25)-L_SPL (MNI x, y, z: -22, -64, 54) than healthy controls (F=4.017, P=0.021), left CS patients exhibited decreased rsFC in R_PCG (MNI x, y, z: 37, -34, 53) -R_PMv (MNI x, y, z: 53, 0, 25) than healthy controls(F=-3.788, P=0.025). Right CS patients exhibited increased rsFC than healthy controls in R_PMd(MNI x, y, z: 28, -10, 54)-L_M1(MNI x, y, z: -38, -22, 56) (F=4.438, P=0.014), right CS patients exhibited increased rsFC than healthy controls in R_PMv(MNI x, y, z: 53, 0, 25)-R_PCG(MNI x, y, z: 37, -34, 53)(F=4.830, P=0.010), right CS patients exhibited decreased rsFC in L_M1(MNI x, y, z: -38, -22, 56)-L_SMA(MNI x, y, z: -5, -4, 57) than healthy controls (F=-5.102, P=0.007). And the left PS patients showed increased rsFC than healthy controls in R_DN -L_SMA (F=4.939, P=0.009), left PS patients exhibited increased rsFC than healthy controls in L_DN-R_SMA (F=3.431, P=0.036), left PS patients exhibited reduced rsFC than healthy controls in R_AICb -R_PMd (F=-4.114, P=0.019). Right PS patients showed increased rsFC compared with healthy controls in L_DN-R_M1(F=3.075, P=0.049), and increased rsFC compared with healthy controls in L_AICb-R_SCb (F=3.725, P=0.027). Conclusion The infarction location poses influence on the FC alteration of the motor network after stroke. Key words: Cerebral infarction; Motor execution network; Functional connectivity; Resting-state fMRI

目的 探讨肝动脉假性动脉瘤相关胆道出血(PARH)介入治疗效果.方法 回顾性分析2012年3月至2016年12月采用血管栓塞术治疗的28例肝动脉假性动脉瘤所致胆道出血患者临床资料.术中血管造影明确假性动脉瘤形态、位置、大小,予以超选择栓塞治疗.术后对症处理,通畅胆道引流,定期随访.结果 28例患者肝动脉PARH诊断明确,胆道出血通过介入栓塞治疗均及时得到控制.术中共应用弹簧圈110枚,无相关并发症发生.术后随访1～36个月,1例肝门部胆管癌患者于介入术后4周死于感染及肝衰竭,2例胆总管癌患者分别于介入术后11.5、14.2个月死于肿瘤进展,2例胃癌患者分别于介入术后4、6.5个月死于肿瘤进展,1例胆总管结石腹腔镜术后患者于介入术后5个月死于并发症冠心病,其他患者恢复良好.结论 介入治疗肝动脉PARH安全、可行,疗效确切.

目的 了解早产儿出生早期凝血功能与胎龄的关系,为早产儿诊治提供依据.方法 记录451例单胎早产儿围生期高危因素(胎盘早剥、妊娠期高血压疾病、妊娠期糖尿病、自发性早产)及出生后基本情况(日龄、性别、胎龄、分娩方式、Apgar评分),于出生后2h内检测其凝血功能指标.根据早产儿胎龄,分为早期早产儿组109例、中期早产儿组111例、晚期早产儿组231例,分析和比较不同胎龄早产儿凝血功能的差异.结果 不同胎龄早产儿胎盘早剥、妊娠期高血压疾病、妊娠期糖尿病、自发性早产等围生期高危因素构成差异无统计学意义(P＞0.05).不同胎龄组早产儿各凝血指标间的差异有统计学意义(P均＜0.05),凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原降解产物(FDP)、D-二聚体(DD)均随胎龄增加呈降低趋势,纤维蛋白原(FIB)则随胎龄增加呈升高趋势;相关分析显示PT、APTT、FDP、DD与胎龄呈负相关(P＜0.05),FIB与胎龄呈正相关(P＜0.05).结论 早产儿出生早期凝血功能主要与胎龄有关,早产儿出生后凝血功能处于不断变化、成熟的过程中,应注意及时复查凝血功能.