Pediatric Hematology/Oncology and ImmunopathologyPediatric Hematology/Oncology and ImmunopathologyВопросы гематологии/онкологии и иммунопатологии в педиатрии1726-17082414-9314Fund Doctors, Innovations, Science for Children21910.24287/1726-1708-2018-17-4-100-113LITERATURE REVIEWОБЗОР ЛИТЕРАТУРЫLaboratory aspects of hemostasis in neonatesЛабораторные аспекты гемостаза новорожденныхhttps://orcid.org/0000-0003-0167-6726KoltsovaE. M.КольцоваЕ. М.
Russian Federation

 PhD, senior research associate of the Laboratory of translational medicine.

117997, Moscow, Samory Mashela st., 1.

канд. биол. наук, старший научный сотрудник лаборатории трансляционной медицины; ученый секретарь Центра теоретических проблем физикохимической фармакологии РАН. 

 117997, Москва, ГСП-7, ул. Саморы Машела, 1. 

ekaterina_koltsova@bk.ruhttps://orcid.org/0000-0002-3741-0770BalashovaE. N.БалашоваЕ. Н.
Russian Federation
https://orcid.org/0000-0002-8128-7757PanteleevM. A.ПантелеевМ. А.
Russian Federation
BalandinaA. N.БаландинаА. Н.
Russian Federation
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian FederationФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава РоссииCenter for Theoretical Problems of Physicochemical Pharmacology.ФГБУН «Центр теоретических проблем физико-химической фармакологии РАН».Kulakov Research Center for Obstetrics, Gynecology and Perinatology, Russian Ministry of Health.ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. академика В.И. Кулакова» Минздрава России.Center for Theoretical Problems of Physicochemical PharmacologyФГБУН «Центр теоретических проблем физико-химической фармакологии РАН»Kulakov Research Center for Obstetrics, Gynecology and Perinatology, Russian Ministry of Health.«Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. академика В.И. Кулакова» Минздрава России.130120191741001131301201913012019Copyright ©; 2019, «D. Rogachev NMRCPHOI»Copyright ©; 2019, ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России2019«D. Rogachev NMRCPHOI»ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава Россииhttps://creativecommons.org/licenses/by/4.0https://hemoncim.com/jour/article/view/219

Newborns have high risks of thrombotic and hemorrhagic complications. Despite the fact that the overall frequency of thrombosis and bleeding in the general population of neonates is low, the risks of both thrombosis and hemorrhage are significantly increased when a newborn has some complications, including prematurity. The mechanisms underlying the onset of thrombotic and hemorrhagic complications in newborns are not fully understood and remain controversial. The hemostasis in newborns drastically differs from adult hemostasis and even from hemostasis in children older than a year. Nevertheless, despite the presence of quantitative and qualitative differences of almost all parameters of the hemostasis system from the parameters of adults, healthy newborns as a whole have clinically normal functional hemostasis without a tendency to coagulopathy or thrombosis. Apparently, the neonatal hemostasis system is in some alternative "balance", which differs from the "balance" of hemostasis in adults. The issue regarding the stability of this balance is still open. Due to the peculiarities of the newborn's hemostasis, clinical laboratory diagnostics of the coagulation disorders is very difficult, and the attending physician is forced to focus exclusively on the clinical picture. This review provides basic information on the neonatal hemostasis system, as well as an attempt to critically evaluate existing laboratory tests in terms of applicability for this group of patients.

Новорожденные составляют группу высокого риска тромботических и геморрагических осложнений. Несмотря на то что в целом частота тромбозов и кровотечений различного характера в общей популяции новорожденных невелика, риски как тромбозов, так и кровотечений существенно повышаются при наличии у новорожденного осложнений, в том числе недоношенности. Механизмы, лежащие в основе возникновения тромботических и геморрагических осложнений у новорожденных, до конца не поняты и остаются спорными. Система гемостаза у новорожденных существенно отличается от гемостаза у взрослых и даже от гемостаза у детей старше 1 года. Тем не менее, несмотря на наличие количественных и качественных отличий практически всех параметров системы гемостаза от параметров у взрослых, здоровые новорожденные в целом имеют клинически нормальный функциональный гемостаз без тенденции к коагулопатии или тромбозу. По-видимому, система гемостаза у новорожденных находится в некотором альтернативном «балансе», который отличается от «баланса» гемостаза у взрослых. Вопрос об устойчивости этого баланса по-прежнему остается открытым. Из-за особенностей гемостаза у новорожденного лабораторная диагностика нарушений этой системы сильно затруднена, и лечащий врач вынужден ориентироваться исключительно на клиническую картину. В данном обзоре приведены основные сведения о системе гемостаза у новорожденных, а также произведена критическая оценка существующих лабораторных тестов с точки зрения их применимости и информативности для данной группы пациентов.

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