未足月胎膜早破患儿呼吸系统病变预测及高危因素分析  

Prediction of respiratory diseases and analysis of risk factors in children with preterm premature rupture of membranes

作　　者：常丽花 张美[1] 孟远翠 李芬霞[1] 赵宗霞[1] 王静[1] Chang Lihua;Zhang Mei;Meng Yuancui;Li Fenxia;Zhao Zongxia;Wang Jing(Department of Obstetrics,the Second Affiliated Hospital of Xi′an Medical College,Xi′an 710038,China;Department of Neonate,the Second Affiliated Hospital of Xi′an Medical College,Xi′an 710038,China)

机构地区：[1]西安医学院第二附属医院产科,710038 [2]西安医学院第二附属医院新生儿科,710038

出　　处：《国际呼吸杂志》2021年第15期1149-1153,共5页International Journal of Respiration

摘　　要：目的建立未足月胎膜早破(PPROM)患儿呼吸系统病变的预测模型并探讨其高危因素。方法前瞻性研究。收集西安医学院第二附属医院2017年1月至2018年12月住院分娩孕28~36周PPROM患者150例的临床资料。根据是否并发呼吸系统病变分为2组,并发呼吸系统病变65例,未并发呼吸系统病变85例。构建logistic回归预测模型,检验其区分度和校准度后利用R语言绘制Nomogram图。采用多元logistic回归分析PPROM患儿并发呼吸系统病变的危险因素。结果PPROM患儿并发呼吸系统病变模型为:logitP=18.660+0.041Age-0.519Week-0.006Time+0.107WBC1-0.125WBC2+0.045NE1-0.063NE2-0.009CRP1+0.021CRP2。绘制Nomogram图可根据母亲年龄、孕周、破膜时间、白细胞计数和中性粒细胞百分比评估患儿并发呼吸系统病变的概率,通过logistic回归分析得出母亲年龄>30岁、新生儿出生体质量<1.5 kg、胎龄<35周、孕晚期发热、宫内窘迫、多胎、剖宫产为PPROM患儿并发呼吸系统病变的危险因素。结论母亲年龄>30岁、新生儿出生体质量<1.5 kg、胎龄<35周、孕晚期发热、宫内窘迫、多胎、剖宫产是导致PPROM患儿并发呼吸系统病变的危险因素。通过建立Nomogram图可预测PPROM患儿发生呼吸系统病变的危险性,从而更好地加以防治。Objective To establish a predictive model of respiratory disease in children with preterm premature rupture of membranes(PPROM)and to explore its risk factors.Methods The clinical data of 150 patients with PPROM from 28th to 36th week of pregnancy in the Second Affiliated Hospital of Xi′an Medical College from January 2017 to December 2018 were prospectively collected.According to whether there were concurrent respiratory diseases,they were divided into two groups:65 patients with systemic lesions and 85 patients with no respiratory disease.A logistic retrospective model was constructed,and the Nomogram was drawn using R language after testing the degree of discrimination and calibration.Multivariate logistic regression was used to analyze the risk factors of respiratory disease in children with PPROM.Results The model of respiratory disease in children with PPROM was:logitP=18.660+0.041Age-0.519Week-0.006Time+0.107WBC1-0.125WBC2+0.045NE1-0.063NE2-0.009CRP1+0.021CRP2.Nomogram was established to estimate the probability of respiratory system disease in children based on maternal age,gestational age,rupture time,white blood cell count and neutrophil percentage.Loigistic regression analysis showed that the age of mother>30 years old,the birth weight<1.5 kg,gestational age<35 weeks,late pregnancy fever,intrauterine distress,multiple births,and cesarean section were risk factors for respiratory disease in children with PPROM.Conclusions The age of mother>30 years old,the birth weight<1.5 kg,gestational age<35 weeks,late pregnancy fever,intrauterine distress,multiple births,and cesarean section are risk factors for respiratory disease in children with PPROM.Nomogram can be used to predict the risk of respiratory diseases in PPROM children,so as to better prevent and treat the disease.

关 键 词：早产 胎膜早破 新生儿 呼吸系统病变 高危因素 预测 

分 类 号：R714.433[医药卫生—妇产科学] R722.1[医药卫生—临床医学]