血清白蛋白水平与极早早产儿重度脑室内出血相关性  

Correlation between Serum Albumin Level and Severe Intraventricular Hemorrhage in Extremely Premature Infants

作　　者：张海娜 薛媛 ZHANG Haina;XUE Yuan(Department of Laboratory Medicine, Kaifeng Children’s Hospital, Kaifeng Henan 475000, China)

机构地区：[1]开封市儿童医院检验科,河南开封475000

出　　处：《河南医学高等专科学校学报》2021年第2期210-214,共5页Journal of Henan Medical College

摘　　要：目的观察出生1 d内血清白蛋白水平与极早早产儿[胎龄(gestational age,GA)<32周]重度脑室内出血(intraventricular hemorrhage,IVH)相关性。方法选取685例极早早产儿(GA<32周),抽取其出生1 d内外周血,检测外周血中白蛋白水平,将白蛋白水平分为<25 g·L^(-1)、25~30 g·L^(-1)和>30 g·L^(-1)。出生7 d后,根据Papile标准以及早产儿是否符合IVH诊断,将其分为重度(Ⅲ~Ⅳ级)IVH组和正常或轻度(Ⅰ~Ⅱ级)IVH组。观察IVH发病率以及出生后1 d内白蛋白水平与IVH相关性。结果685例极早早产儿中,轻度IVH发病率为47.7%,重度IVH发病率为7.0%。2组早产儿GA、出生体质量(BW)、产前倍他米松治疗、NaHCO3治疗酸中毒、重度窒息史、机械通气史、白蛋白水平、经阴道分娩比较,差异均有统计学意义(P<0.05)。GA、BW、产前倍他米松治疗、重度窒息史、机械通气史、白蛋白水平<25 g·L^(-1)是GA<32极早早产儿重度(Ⅲ~Ⅳ级)IVH的独立危险因素(P<0.05),出生24 h血清白蛋白预测重度IVH特异度为68.7%,灵敏度为78.9%。结论出生后1 d内白蛋白水平<25 g·L^(-1)早产儿更易发生严重IVH,应引起临床重视。Objective To observe the correlation between serum albumin level and severe intraventricular hemorrhage(IVH)in extremely premature infants[gestational age(GA)<32 weeks]within 1 day of birth.Methods A total of 685 extremely premature infants(GA<32 weeks)within 1 day of birth were selected to detect albumin levels in peripheral blood.The protein level was divided into<25 g·L^(-1),25-30 g·L^(-1),and>30 g·L^(-1).Seven days after birth,according to the Papile criteria and whether the premature infants met the IVH diagnosis,extremely premature infantswere divided into severe(Ⅲ~Ⅳ)IVH group and normal or mild(ⅠtoⅡ)IVH group.The incidence of IVH and the correlation between albumin levels and IVH in extremely premature infants within 1 day after birth were observed.Results Among the 685 premature infants,the incidence of mild IVH was 47.7%,and the incidence of severe IVH was 7.0%.GA,birth weight(BW),prenatal betamethasone treatment,NaHCO3 treatment acidosis,severe asphyxia history,mechanical ventilation history,albumin level,and vaginal delivery were compared between the two groups respectively,and the differences were statistically significant(P<0.05).GA,BW,prenatal betamethasone treatment,history of severe asphyxia,history of mechanical ventilation,or albumin level<25 g·L^(-1) were independent risk factors of(ⅢtoⅣ)IVH for very premature infants(P<0.05).The serum albumin in 24 h after birth predicted a specificity of 68.7%for severe IVH,a sensitivity of 78.9%.Conclusion Premature infants with albumin levels<25 g·L^(-1) within 1 day after birth are more likely to develop severe IVH,which should cause clinical attention.

关 键 词：重度脑室内出血 早产儿 危险因素 白蛋白 

分 类 号：R446.1[医药卫生—诊断学] R743[医药卫生—临床医学]