摘要
目的 探讨胎龄小于32周早产儿发生支气管肺发育不良(BPD)及病情程度的风险因素.方法 425例胎龄小于32周早产儿分为对照组(未发生BPD,307例)和BPD组(118例),将BPD组再分为轻度组(75例)和中重度组(43例);收集各组早产儿(性别、年龄、出生体质量、娩出方式、Apgar评分、合并症、有创机械通气、输血次数等)和产妇(高龄、试管婴儿、多胎、分娩史、合并症及糖皮质激素使用情况等)的临床资料;采用多因素logistic回归分析胎龄小于32周早产儿发生BPD及中重度中重度BPD的相关相关因素.结果 胎龄(OR=0.474,95％CI 为 0.290～0.755)、出生体质量(OR=0.994,95％CI 为 0.992～0.997)、产前使用糖皮质激素(OR=0.356,95％CI为 0.131～0.967)、PDA(OR=3.455,95％CI为 1.304～9.150)、输血次数≥3 次(OR=3.350,95％CI为 1.192～9.419)是发生 BPD 的独立影响因素(P＜0.05);出生体质量(OR=0.996,95％CI为0.992～1.000)、有创机械通气时间(OR=3.246,95％CI为1.286～18.203)是发生中重度BPD的独立影响因素(P＜0.05).结论 胎龄、出生体质量、产前使用糖皮质激素、动脉导管未闭及输血次数是胎龄小于32周早产儿发生BPD的独立影响因素,出生体质量、有创机械通气时间是发生中重度BPD的独立影响因素.
Abstract
Objective To summarize the risk factors for its occurrence and severity of bronchopulmonary dysplasia(BPD).Methods A total 425 preterm infants with gestational age less than 32 weeks were divided into the control group(307 cases without BPD)and BPD group(118 cases).BPD group was further divided into mild BPD group(75 cases)and moderate/severe BPD group(43 cases).Clinical data of preterm infants were collected,including gender,age,birth weight,delivery mode,Apgar score,comorbidities,invasive machinery,blood transfusion frequency,etc.and the data of maternal mothers were recorded,including old age,IVF,multiple births,delivery history,comorbidities,and glucocorticoid use,etc.Multivariate logistic regression was used to analyze the factors affecting the occurrence of BPD in preterm infants with gestational age less than 32 weeks and the severity of BPD.Results Gestational age(OR=0.474,95％CI was 0.290-0.755),birth weight(OR=0.994,95％CI was 0.992-0.997),prenatal glucocorticoid use(OR=0.356,95％CI was 0.131-0.967),PDA(OR=3.455,95％CI was 1.304-9.150),and the number of blood transfusions ≥ 3(OR=3.350,95％CI was 1.192-9.419)were independent influencing factors for BPD(P＜0.05).Birth weight(OR=0.996,95％CI was 0.992-1.000)and invasive mechanical ventilation time(OR=3.246,95％CI was 1.286-18.203)were independent factors for the occurrence of moderate/severe BPD(P＜0.05).Conclusions Gestational age,birthweight,prenatal glucocorticoid use,ductus arteriosus,and blood transfusion frequency are independent factors for the occurrence of BPD in preterm infants less than 32 weeks of gestational age.Birth weight and invasive mechanical ventilation time are independent factors for the occurrence of moderate/severe BPD.
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