目的 分析新生儿持续肺动脉高压(PPHN)生存质量的影响因素.方法 采取回顾性研究,选取2020年1月至2023年1月收治的120例患儿临床资料.患儿均参照《新生儿肺动脉高压诊治专家共识》行常规治疗,根据预后情况分组.将预后良好(氧合指数较基础值增加＞20 mm Hg或病情好转或治愈出院)患儿纳入生存质量良好组,将预后不良(症状无改善或放弃或病死)患儿纳入生存质量差组.统计患儿基线资料,采用二元logistic回归分析PPHN生存质量的影响因素;采用接受者操作特性曲线(ROC)分析各影响因素对PPHN患儿生存质量的预测价值.结果 生存质量差组低血压、急性肾损伤患儿[32.26％(10/31)、29.03％(9/31)]占比高于生存质量良好组[12.36％(11/89)、7.87％(7/89)],血清 IL-1β、vWF、HMGB[(35.63±4.37)ng/L、(235.64±15.68)％、(28.64±3.37)μg/L]及血常规 RDW 水平[(21.87±4.18)％]高于生存质量良好组[(29.37±4.28)ng/L、(218.37±14.28)％、(24.47±3.19)μg/L、(17.58±3.64)％],差异均有统计学意义(P＜0.05);行二元logistic回归分析结果显示,有低血压、急性肾损伤,血清IL-1β、vWF、HMGB高表达是PPHN患儿生存质量差的危险因素(OR＞1,P＜0.05);绘制ROC曲线结果显示,各因素联合预测PPHN患儿生存质量差的AUC为0.934(95％CI:0.893～0.975,P＜0.001).结论 低血压、急性肾损伤,血清IL-1β、vWF、HMGB水平与PPHN患儿生存质量密切相关,同时各因素联合能够有效预测患儿生存质量.
Multivariate regression analysis of quality of life in neonates with persistent pulmonary hypertension
Objective To analyze the influencing factors for the quality of life in neonates with persistent pulmonary hypertension(PPHN).Methods It was a retrospective study involving 120 PPHN neonates from January 2020 to January 2023.All patients were treated with routine treatment according to the Expert Consensus on the Diagnosis and Treatment of Neonatal Pulmonary Hypertension.According to the prognosis,they were assigned into good quality of life group(good prognosis of improved condition/cure for discharge with oxygenation index increased by more than 20mmHg than baseline)and poor quality of life group(no improvement in symptoms or abandonment/death).The baseline data of the children were collected,and the influencing factors for the quality of life of PPHN were analyzed by binary logistic regression.The receiver operating characteristic(ROC)curve was used to analyze the predictive values of each influencing factor in the quality of life of children with PPHN.Results The proportions of children with hypotension(32.26％[10/31]vs 12.36％[11/89])and acute kidney injury(29.03％[9/31]vs 7.87％[7/89])in the poor quality of life group were significantly higher than those of the good quality of life group(P＜0.05).Serum interleukin 1 β(IL-1 β,[35.63±4.37]ng/L vs[29.37±4.28]ng/L),Von Willebrand factor(vWF,235.64％±15.68％vs 218.37％±14.28％)and high mobility group box protein(HMGB,[28.64±3.37]μg/L vs[24.47±3.19]μg/L)and red cell distribution width(RDW,21.87％±4.18％vs 17.58％±3.64％)were significantly higher in the poor quality of life group than those of the good quality of life group(P＜0.05).The results of binary logistic regression analysis show that hypotension,acute kidney injury,and high serum IL-1β,vWF and HMGB levels were risk factors for poor quality of life in children with PPHN(OR＞1,P＜0.05).ROC curve showed that the area under the curve(AUC)of the combination detection of risk factors for predicting the poor quality of life in children with PPHN was 0.934(95％CI 0.893-0.975,P＜0.001).Conclusion Hypotension,acute kidney injury,serum IL-1β,vWF and HMGB levels are closely related to the quality of life of children with PPHN,and the combination detection of various factors can effectively predict the quality of life of children.
neonatal persistent pulmonary hypertensionquality of liferegression analysisfactors
NETL
NSTL
万方数据
