新生児頭蓋内出血における血液凝固・線溶・血小板系の関与

Abstract

Coagulation studies were carried out in 55 newborn infants with intracranial hemorrhage diagnosed by using cerebral CT, spinal tap and/or the findings at autopsy, excluding the cases with intracranial hemorrhage caused by birth trauma. Decrease of plasma fibrinogen, hepaplastintest values and platelet counts, and prolongation of APTT were observed in a majority of these cases. Based on the findings of hemodynamics, blood gas analysis and coagulation status, it was estimated that the causes of intracranial hemorrhage were definite DIC in 14 cases, probable DIC in 6 cases, vitamin K dependent coagulation factors deficiency in 8 cases, rupture of cerebral tumor in 2 cases, cerebral anomaly in 2 cases and increased carotid artery pressure in 2 cases, respectively. On the other hand, the causes of intracranial hemorrhage in 14 cases were unknown, and the causes in 7 cases could not be estimated because of lack of sufficient data. Mortality of the cases with DIC and/or vitamin K dependent coagulation factor deficiency was significantly higher than that of cases without major coagulation abnormalities.We suggest that abnormalities of hemostasis are responsible for the occurrence and/or exacerbation of intracranial hemorrhage in newborn infants.