INDICES OF SYSTEMIC INFLAMMATION IN VERY LOW BIRTH WEIGHT PRETERM INFANTS WITH SEVERE PERINATAL PATHOLOGY
DOI:
https://doi.org/10.11603/24116-4944.2024.2.15087Keywords:
children, preterm birth, hypoxia, perinatal pathology, complete blood count, ratio of NLR, PLR, MLR, systemic inflammation indices SII, SIRI, PIVAbstract
The aim of the study – to study the effectiveness of determining indices of systemic inflammation based on hematological indicators in children with a gestational age at birth of <32 weeks under conditions of hypoxia in perinatal pathology.
Materials and Methods. The primary study cohort comprised 54 children with a gestational age of <32 weeks who exhibited severe forms of perinatal pathology. The comparison cohort consisted of 31 newborns with a gestational age of 34–36/6 weeks who demonstrated satisfactory adaptation in the early neonatal period. A comprehensive clinical and laboratory examination of the newborns was conducted in accordance with standard protocols. Based on the results of the complete blood count, additional ratios of indicators were determined. The following ratios were calculated: NLR (neutrophil to lymphocyte ratio), PLR (platelet to lymphocyte ratio), and MLR (monocyte to lymphocyte ratio); additionally, the following indices were calculated: SII (systemic immune inflammation index); SIRI (systemic inflammation response index); PIV (platelet, neutrophil, monocyte, and lymphocyte index). The statistical analysis was conducted using STATISTICA software (StatSoft Inc., USA, Version 10). Quantitative indicators with a normal distribution were compared using Student's t-test. The probability of differences was considered statistically significant at p<0.0001.
Results and Discussion. The severity of the condition of newborns is accompanied by characteristic changes in complete blood count parameters, including ratios and indices. The results demonstrated specific alterations that suggest the presence of distinctive deviations in the indicators when compared to the control group. This indicates a disruption in the activation of erythroid, myeloid, and granulocyte hematopoiesis pathways in response to hypoxia during the early neonatal period in extremely preterm infants. The utilization of these indicators provides a degree of insight into the pathophysiological alterations occurring in the bodies of children in the context of hypoxic inflammation during preterm birth.
Conclusions. The determination of the ratio of complete blood count (CBC) and systemic inflammation indices represents a significant advancement in the field of laboratory diagnosis for newborns with diverse forms of perinatal pathology. In the cohort of newborns with a gestational age of <32 weeks, the severity of the condition is confirmed by an increase in the NLR index to 0.332, a decrease in the PLR index to 5.331 and MLR to 0.060, a decrease in the SII index to 63.342, the SIRI index to 0.713, and an increase in the PIV index to 199.260. The calculation of the ratio of complete blood count and systemic inflammation indices represents an additional effective criterion for the severity of the condition of newborns. Furthermore, it allows for the objective assessment of certain pathophysiological links of hypoxic damage and their features in preterm infants.
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