早产儿脑室周围-脑室内出血高危因素Logistic多元回归分析  

Logistic Multiple Regression Analysis of Risk Factors for Periventricular and Intraventricular Hemorrhage in Premature Infants

作　　者：刘冲冲 金小兰[1] 唐文燕[1] 

机构地区：[1]江西省妇幼保健院新生儿科,江西南昌330000

出　　处：《长江大学学报（自然科学版）》2018年第12期39-41,70,共4页Journal of Yangtze University(Natural Science Edition)

摘　　要：目的:探讨早产儿脑室周围-脑室内出血(PIVH)的高危因素及防治措施。方法:回顾性搜集2014年12月~2016年12月出现PIVH的早产患儿的临床资料62例,记录其性别、孕周(GA)、出生体重(BW)、母亲年龄、孕次、产次、生产方式、是否多胎、有无胎盘异常、宫内窘迫或窒息、母亲孕期合并症、羊膜早破、羊水异常、脐带异常、低体温、血糖紊乱、贫血、机械通气(IMV)、酸中毒、血小板减少、低血钠、低血钙、蓝光照射、生后有无应用氨茶碱或咖啡因、鲁米钠、利尿剂以及有无新生儿呼吸窘迫综合征(NRDS)等27个因素的资料,同时随机抽取64例同期住院的无PIVH的早产儿作为对照组。使用Logistic二项回归分析逐步向前引入法找出影响早产儿PIVH的最主要的高危因素,同时构建公式计算PIVH的预报概率并采用Hosmer&Lemeshow检验和ROC曲线评估模型。结果:从多因素逐步Logistic回归分析结果来看,影响早产儿PIVH发生的最主要因素是宫内窘迫或窒息,其次为糖代谢紊乱、呼吸机应用、GA≤32周和BW≤2000g。结论:我国早产儿颅内出血的防治重点应是有围生期缺血缺氧史、出生窒息史及低体重、小于胎龄、生后发生低血糖或高血糖、生后使用呼吸机治疗等高危因素的早产儿。Objective:This paper was to investigate the relative high-risk factors of Peri-intraventricular hemorrhage(PIVH)in premature infants for prevention and treatment in premature infants at risk.Methods:This paper retrospectively analyzed the clinical information of 62premature infants with the ultrasound or CT diagnosis of PIVH who had been hospitalized in NICU form Dec 2014to Dec 2016,and recorded twenty-seven characteristics,including Gender;Gestational age,Birth weight,Maternal age,Delivery mode,Parity,Gravidity,Placenta abnormal(abruption or previa),Amniotic fluid abnormal,Umbilical cord abnormal,whether Multi-gravide,Distress or Asphyxia,Maternal pregnancy complication(HDP,ICP,colporrhagia,DM,metrosynizesis and so on),Premature rupture of amniotic membrane,Hyponatremia,Hypocalcemia,Hypothermia,Glucose metabolism disorders,Anemia,Mechanical ventilation,Acidosis,Thrombocytopenia,Blue light irradiate,whether using Aminophylline or Caffeine,Luminal or Diuretic and Respiratory distress syndrome.At the same time,64premature infants who were although submitted to the same evaluation protocol did not show any echographic signs of hemorrhage were taken at random in the corresponding period.This paper uses stepwise forward logistic multiple regression analysis to find the principal high-risk factor of PIVH in premature infants.These significant variables were subjected to construct a formula to calculate the probability of PIVH.The model was calibrated by Hosmer&Lemeshow Test and its discriminative power assessed using receiver operating characteristic(ROC)curves.Results:Stepwise logistic multiple regression analysis showed Distress or Asphyxia,Mechanical ventilation,Gestational age≤32w,Birth weight≤2000g and Glucose metabolism disorders were principal high-risk factors related to PIVH.Conclusions:The most principal high-risk factor of PIVH in premature infants is Distress or Asphyxia.Other significant variables were Mechanical ventilation,Gestational age≤32w,Birth weight≤2000g and Glucose metabolism disorders In

关 键 词：早产儿 脑室周围脑室内出血 

分 类 号：R714.42[医药卫生—妇产科学]