我国早产儿脑室周围白质软化发生率的多中心调查报告  

Multicenter investigation for incidence of periventricular leukomalacia in premature infants in China

作　　者：陈惠金[1] 魏克伦[2] 姚裕家[3] 杨于嘉[4] 周丛乐[5] 范秀芳[6] 高喜容[7] 江莲[8] 刘晓红[9] 钱继红[10] 王莉[11] 吴本清 吴高强 张青梅[14] 张小兰[15] 周晓玉[16] 

机构地区：[1]上海交通大学医学院附属新华医院,上海市儿科医学研究所 [2]中国医科大学附属二院 [3]四川大学华西第二医院 [4]中南大学湘雅医院 [5]北京大学第一医院 [6]山东省济南市妇幼保健院 [7]湖南省儿童医院 [8]河北医科大学第四医院 [9]深圳市儿童医院 [10]上海交通大学医学院附属新华医院 [11]新疆医科大学一附院 [12]新疆乌鲁木齐市妇幼保健院 [13]深圳市人民医院 [14]沈阳市妇婴医院 [15]深圳市妇幼保健院 [16]南京大学附属南京儿童医院

出　　处：《中国当代儿科杂志》2008年第6期686-692,共7页Chinese Journal of Contemporary Pediatrics

基　　金：中华医学会儿科分会新生儿学组立项课题

摘　　要：目的在中华医学会儿科分会新生儿学组的发起下,国内十余家大型医院于2005年1月始进行了为期近两年的《早产儿脑损伤》多中心协作研究。该文报告我国10家三级甲等医院近两年对早产儿脑室周围白质软化(PVL)发生率的调查结果。方法2005年1月至2006年8月期间,各参加单位对所有胎龄<37周的早产儿在生后7d内常规进行初次床边头颅B超检查,以后每隔3～7d复查一次,直至出院。结果10单位共出生或收住早产儿4933例,总PVL发生率为2.3%(112/4933),囊性PVL发生率为0.3%(16/4933)。分别为Ⅰ级PVL85.7%(96/112),Ⅱ级PVL12.5%(14/112),Ⅲ级PVL1.8%(2/112),无IV级PVL。4家妇婴医院的早产儿PVL总发生率非常显著低于6家综合性或儿童专科医院(1.4%vs.2.8%)(χ2=10.284,P<0.01)。与发生囊性PVL相关的可能高危因素为阴道分娩和机械呼吸。结论该调查数据基本可以反映我国主要大城市早产儿PVL发生率的情况。提高对PVL尤其是非囊性脑室周围白质损伤的超声识别率,是今后临床要大力加强的重点。Objective Sponsored by the Subspecialty Group of Neonatology of Pediatric Society, China Medical Association, more than 10 large-scale hospitals participated in the near two-year muhicenter investigation for brain injuries in premature infants in China. This study presented the investigation result for the incidence of periventricular leukomalacia （PVL） in premature infants from 10 Third Class A Level hospitals. Methods The premature infants with a gestation age 〈 37 weeks in the 10 hospitals were given routine cranial ultrasound scanning within seven days after birth, and then repeated every 3-7 days until discharge from January 2005 to August 2006. The severity of PVL was graded based on de Vries classification. Results A total of 4 933 premature infants were enrolled. The total incidence of PVL and the incidence of cystic PVL were 2.3% （112/4 933） and 0.3% （16/4 933）, respectively. Of the 112 PVL cases, 96 （85.7%） were with grade Ⅰ, 14 （ 12.5% ） with gradeⅡ, and 2 （ 1.8% ） with grade Ⅲ. The incidence of PVL in 4 maternal and child health care hospitals were significantly lower than that in 6 general or children＇ s hospitals （ 1.4% vs 2.8% ） （χ^2= 10. 284, P 〈 0.01 ）. Vaginal delivery and mechanical ventilation were possible high-risk factors for the development of cystic PVL. Conclusions The data of the muhicenter investigation can basically reflect the situation about the occurrence of PVL in premature infants in major big cities of China. It is important to improve the ability to recognize the sonogram of non-cystic periventricular white matter injury.

关 键 词：早产儿 脑室周围白质软化 发生率 多中心研究 中国 

分 类 号：R722.6[医药卫生—儿科]