Risk factors of respiratory distress syndrome in premature infants and the therapeutic value of inhaled corticosteroid
Objective To analyze the risk factors of respiratory distress syndrome(RDS)in premature infants and the therapeutic effect of inhaled corticosteroid(ICS).Methods 60 cases of RDS premature infants were randomly divided into one group(ICS treatment,30 cases)and two group(sodium chloride injection nebulized inhalation treatment,30 cases).The clinical characteristics of premature infants with RDS were analyzed,and multivariate Logistic regression analysis of RDS was performed.The duration of symptom reduction,incidence of adverse reactions,and laboratory indicators[red blood cell volume distribution width(RDW),lactate value,interleukin-8(IL-8)]were compared between the two groups.Results The percentage of cesarean section,asphyxia,amniotic fluid inhalation,placental abruption,intrauterine distress,placenta previa,premature rupture of membranes and prenatal hormone administration was very high in premature infants with RDS.Multivariate Logistic regression analysis showed that asphyxia[SE=0.57;95%CI=(1.05,8.37);P=0.03<0.05]and intrauterine distress[SE=0.29;95%CI=(1.16,3.37);P=0.01<0.05]were risk factors for RDS.Placental abruption[SE=0.31;95%CI=(0.07,0.97);P=0.03<0.05]and prenatal hormone administration[SE=0.27;95%CI=(0.00,0.93);P=0.02<0.05]were protective factors for RDS.The time to reduction of pulmonary rales symptoms was(5.92±1.03)d in one group and(7.35±1.14)d in two group,and there was a difference in comparison(t=5.10,P=0.00<0.05).The time to reduction of nasal obstruction symptoms in one group and two group were(6.22±1.05)and(8.48±1.16)d,and there was a difference in comparison(t=7.91,P=0.00<0.05).The time of reduction of dyspnea in one group and two group were(5.21±0.79)and(6.57±0.97)d,and there was a difference in comparison(t=5.95,P=0.00<0.05).There was no difference in comparison of the incidence of adverse reactions between the two groups of premature infants(χ2=0.74,P=0.39>0.05).After treatment,RDW,lactate value and IL-8 in one group were(13.35±1.72)%,(2.84±0.69)mmol/L and(234.15±14.29)pg/ml,and those in two group were(18.74±1.78)%,(4.11±0.76)mmol/L and(360.15±14.95)pg/ml,there was a statistical difference in comparison(t=11.93,6.78,33.37;P=0.00,0.00,0.00<0.05).Conclusion The main risk factors of premature infants with RDS are intrauterine distress and asphyxia.After ICS treatment,all indicators will be improved.
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