早产儿支气管肺发育不良发生的高危因素及新生儿急性生理学评分对其的预测价值  

Risk factors of bronchopulmonary dysplasia in preterm infants and predictive value of Score for Neonatal A- cute Physiology on incidence of bronchopulmonary dysplasia

作　　者：严洁[1] 何蓉[1] 肖志辉[1] 李艳红[1] 冯星[1] 

机构地区：[1]苏州大学附属儿童医院新生儿科,215003

出　　处：《中华实用儿科临床杂志》2013年第14期1080-1082,共3页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的探讨早产儿支气管肺发育不良（BPD）发病的危险因素，以及新生儿急性生理学评分（SNAP）对预测BPD发生风险的临床应用价值。方法对202例胎龄〈35周早产儿（分为BPD组及非BPD组）的临床资料进行回顾性分析，并对研究对象在入院23,h内进行SNAP评分，分析BPD发病的危险因素及SNAP与BPD发生的相关性。结果BPD组胎龄、出生体质量、5minApgar评分、血清清蛋白与非BPD组比较，差异均有统计学意义（P均〈0．05）。BPD组呼吸窘迫综合征、呼吸暂停、呼吸衰竭、产后感染、贫血、动脉导管未闭、早产儿脑损伤的发生率均显著高于非BPD组，且住院期间机械通气次数、机械通气总时间及总吸氧时间均明显长于非BPD组（P均〈0．05）。多因素Logistic回归分析显示胎龄、SNAP、产后感染及频发呼吸暂停均是BPD发病的独立危险因素（P均〈0．05）。SNAP预测BPD发生的敏感性为88．6％。结论临床资料证实BPD的发生与多因素相关，为BPD的进一步研究提供了有用信息，且早产儿入院时的SNAP可用于预测BPD的发生，以采取积极的措施预防和减少BPD的发生。Objective To investigate the risk factors of bronchopulmonary dysplasia （BPD） in preterm in- fants ,and to explore the clinical application value of Score for Neonatal Acute Physiology（SNAP） in predicting the de- velopment of BPD. Methods The clinical and laboratory data of 202 premature infams with gestational age 〈 35 weeks were reviewed. The premature infants were divided into BPD group and non-BPD group, the SNAP values for each infant during the first 24 hours of admission were calculated, the risk factors of BPD were analyzed, and the relationship be- tween SNAP and the development of BPD was analyzed. Results There were significant differences in gestational age, birth weight and 5 rain Apgar score, serum albumin between BPD group and non-BPD group （ all P 〈 0.05 ）. The inci- dences of respiratory distress syndrome, apnea of prematurity, respiratory failure, hospital-acquired infection, anemia, pa- tent ductus arteriosus, brain damage in BPD group were significantly higher than those in non-BPD group （ all P 〈 0. 05 ）. In addition, compared with non-BPD group, the times and duration of mechanical ventilation and oxygen therapy were longer in BPD group （all P 〈 0.05 ）. Multivariate Logistic regression revealed that gestational age, SNAP, hospital- acquired infection, and apnea of prematurity were independent risk factors of BPD （ all P 〈 0.05 ）. The sensitivity of the SNAP was 88.6% in predicting the development of BPD. Conclusions The development of BPD in premature infants is related with multiple factors, which provide useful information for further research on BPD. In addition, the SNAP values in premature infants can be used to predict the development of BPD.

关 键 词：支气管肺发育不良 新生儿急性生理学评分 高危因素 婴儿 早产 

分 类 号：R722.6[医药卫生—儿科]