吸入一氧化氮治疗低氧血症早产儿反应的相关因素  

Research on the related factors of response to inhaled nitric oxide treatment in premature infants with hypoxemia

作　　者：卢涛 郝建民 邱娟 张鑫 李春红 孟宪英 Lu Tao;Hao Jian-min;Qiu Juan;Zhang Xin;Li Chun-hong;Meng Xian-ying(Department of Gynecology,Kaifeng Maternal and Child Care Center,Kaifeng 475000,China)

机构地区：[1]开封市妇幼保健院妇产科,河南开封475000 [2]开封市中心医院妇科,河南开封475000 [3]开封市第二人民医院妇产科,河南开封475002

出　　处：《中国急救医学》2020年第5期411-416,共6页Chinese Journal of Critical Care Medicine

摘　　要：目的评价急性低氧血症(AH)早产儿吸入一氧化氮(INO)治疗后反应的相关因素。方法选取2017年7月至2019年6月在开封市妇幼保健院新生儿监护病房(NICU)进行INO治疗的AH早产儿的临床资料。根据INO治疗后AH早产儿是否有反应,将早产儿分为反应早产儿组(反应组)与无反应早产儿组(无反应组),统计AH早产儿INO治疗反应发生率。收集并比较两组早产儿的临床和预后资料,采用单变量和多变量分析评价INO治疗后早产儿反应的相关因素。结果纳入的92例AH早产儿的反应发生率为64.1%(59/92)。多变量Logistics回归分析表明,肺动脉高压(OR=5.269,95%CI 1.102~25.322,P=0.001)和出生至INO治疗间隔时间(OR=0.927,95%CI 0.866~0.992,P=0.013)是INO治疗后AH早产儿反应的独立相关因素,胎龄不是早产儿反应的独立相关因素(OR=0.963,95%CI 0.791~1.170,P=0.582)。反应组早产儿脑室内出血Ⅲ/Ⅳ级比例较无反应组明显升高(χ2=4.598,P=0.032),NICU住院时间明显降低(t=2.033,P=0.045)。结论肺动脉高压和出生至INO治疗间隔时间是INO治疗后AH早产儿反应的独立相关因素,肺动脉高压的AH早产儿INO治疗的疗效更好,AH早产儿应尽早进行INO治疗。Objective To evaluate the factors related to the response of premature infants with acute hypoxemia(AH)after inhaled nitric oxide(INO).Methods Clinical data of AH premature infants who underwent INO treatment in our neonatal intensive care unit from July 2017 to June 2019 were selected.According to whether AH premature infants responded after INO treatment,the children were divided into response group and non-response group,and the incidence of INO treatment response in AH premature infants was counted.The clinical and prognostic data of the two groups were collected and compared.The univariate and multivariate analysis were used to evaluate the factors related to the response of children after INO treatment.Results The incidence of response in 92 AH premature infants was 64.1%(59/92).Multivariate Logistic regression analysis showed that pulmonary hypertension(OR=5.269,95%CI 1.102-25.322,P=0.001)and the interval from birth to INO treatment(OR=0.927,95%CI 0.866-0.992,P=0.013)were independent factors in response to INO treatment,and gestational age was not independently related factors of response(OR=0.963,95%CI 0.791-1.170,P=0.582).Compared with the non-response group,the proportion of children with gradeⅢ/Ⅳintraventricular hemorrhage in the response group(χ2=4.598,P=0.032)was significantly increased,and the length of hospital stay in the NICU(t=2.033,P=0.045)was significantly reduced.Conclusion Pulmonary hypertension and the interval from birth to INO treatment are independent factors related to the response of children after INO treatment.The effect of INO treatment on AH children with pulmonary hypertension is better.AH premature infants should be treated with INO as soon as possible.

关 键 词：急性低氧血症(AH) 早产儿 吸入一氧化氮(INO) 反应率 肺动脉高压 

分 类 号：R722.6[医药卫生—儿科]