早产儿代谢性骨病的高危因素分析  

Risk factors of metabolic bone diseases of prematurity

作　　者：王美茜 武彦秋[1] 刘利蕊[1] 周启立[1] 赵宏伟[1] 曹芮 刘霞[1] WANG Mei-xi;WU Yan-qiu;LIU Li-rui;ZHOU Qi -li;ZHAO Hong-wei;CAO Rui;LIU Xia(Department of Pediatrics, Affiliated Hospital of Chengde Medical College, Chengde067000, Hebei, China)

机构地区：[1]承德医学院附属医院儿科,河北承德067000

出　　处：《广东医学》2019年第8期1109-1112,共4页Guangdong Medical Journal

基　　金：河北省人口和计划生育委员会科研计划指令课题(编号:2013-A21)

摘　　要：目的探讨早产儿发生代谢性骨病(MBDP)的高危因素。方法选取定期随访的早产儿297例,根据碱性磷酸酶(ALP)及血磷情况分为MBDP组和非MBDP组,回顾性分析两组早产儿的产前因素、出生情况、住院期间情况等资料。结果 297例早产儿中,发生MBDP 149例(50.17%)。胎龄越小、出生体重越低、存在宫内生长发育迟缓(IUGR)的早产儿发生MBDP的比例明显升高;母孕期患妊娠期高血压、糖尿病及妇科炎症及胎膜早破早产儿MBDP的发生率高;住院时间、应用静脉营养时间、机械通气时间及合并感染的比例亦为MBDP发生的高危因素;MBDP组住院期间呋塞米、苯巴比妥钠、咖啡因等药物的使用率明显升高。Logistic回归分析显示,出生胎龄、出生体重、IUGR是MBDP发生的独立危险因素。结论 32周以下早产儿MBD发生率较高,尤其是合并IUGR的早产儿或极低出生体重儿;预防孕期高血压、糖尿病等疾病的发生,生后早期的肠内营养,合理应用呋塞米、苯巴比妥钠、咖啡因等药物将会在一定程度上减少MBDP的发生。Objective To investigate the correlated factors contributed to metabolic bone diseases(MBDP) of prematurity. Methods A total of 297 preterm infants born in our hospital from October 2015 to July 2018 were enrolled. They were classified into MBDP and non-MBDP groups according to alkaline phosphatase(ALP) and serum phosphorus. The perinatal data, birth data and hospitalization data were compared between the two groups. Results MBDP occurred in 149(50.17%) infants among the 297 infants on discharge. The incidence of MBDP was increased with the decreases of gestational age at birth and birth weight. The incidence of MBDP was significantly increased in intrauterine growth restriction(IUGR) infants, and maternal gestational hypertension, diabetes, gynecological inflammation and premature rupture of membranes cases. Compared with the non-MBDP group, the hospital stay, the duration of parenteral nutrition, the duration of ventilation support and the incidences of infection were significantly higher in the MBDP group. The utilization rates of furosemide, phenobarbital sodium and caffeine in the MBDP group was significantly higher than those in the non-MBDP group. The logistic regression analysis showed that birth weight, gestational age at birth and IUGR were independent risk factors for MBDP. Conclusions The prevalence of MBDP is high in premature infants under 32-week gestation age, especially in those complicated with weight. To prevent the occurrence of diseases such as the prevention of hypertension and diabetes during pregnancy, reasonable nutrition support after birth, and reasonable application of furosemide,phenobarbital sodium and caffeine will reduce the occurrence of MBDP.

关 键 词：代谢性骨病 早产儿 高危因素 

分 类 号：R722.6[医药卫生—儿科] R589[医药卫生—临床医学]