极低出生体质量儿宫外生长发育迟缓的预测模型建立  

Establishment of prediction model of extrauterine growth retardation of very low birth weight infants

作　　者：肖玉联 韦茹 王静[1] 杨延萍 胡丹丹 XIAO Yulian;WEI Ru;WANG Jing;YANG Yanping;HU Dandan(Department of Health Care,Guangzhou Women and Children’s Medical Centre,Guangzhou 510630,China)

机构地区：[1]广州市妇女儿童医疗中心儿童保健科,广州510630

出　　处：《实用医学杂志》2022年第1期62-67,共6页The Journal of Practical Medicine

基　　金：广东省医学科研基金项目(编号:B2021257)。

摘　　要：目的观察极低出生体质量儿宫外生长发育情况,并建立发育迟缓的预测模型。方法纳入2019年1月至2021年1月我院收治的804例极低出生体质量儿为研究对象。统计804例患儿宫外生长发育迟缓(EUGR)发生率,依据是否发生EUGR,将患儿分为EUGR组(n=567)和非EUGR组(n=237),对比两组患儿住院期间各项基础资料信息差异,再将有差异变量纳入logistic回归分析,并进行量化赋值,以是否发生EUGR为因变量(Y,是=1,否=0),以IUGR、出生体重、恢复出生体重时间、开始肠内营养时间、败血症、NRDS、第1周末氨基酸量为自变量(X),明确极低出生体质量儿发生EUGR的危险因素,最后绘制危险因素的ROC曲线,建立极低出生体质量儿发生EUGR的预测模型。结果804例极低出生体质量儿中发生EUGR 567例,占70.52%,均纳入EUGR组,其中患儿6月龄时身高小于同年龄同性别2个标准差者254例,体质量小于同年龄同性别2个标准差者285例,头围小于同年龄同性别2个标准差者154例;未发生EUGR 237例,占29.48%,均纳入非EUGR组。两组性别、胎龄、出院体重、住院天数、Apgar评分、肠外营养持续时间、全经口喂养时间、全经口最大热量及第1、2周末脂肪乳量及能量摄入、第2周末氨基酸摄入、是否合并化脓性脑膜炎、新生儿支气管肺发育不良(BPD)、脑血管病(ICH)各项信息对比均差异无统计学意义(P>0.05);EUGR组出生体重、第1周末氨基酸量均显著低于非EUGR组,开始肠内营养时间、恢复出生体重时间均显著晚于非EUGR组,合并宫内生长发育迟缓(IUGR)、败血症、新生儿呼吸窘迫综合征(NRDS)患儿占比均显著高于非EUGR组(P<0.05)。经logistic回归性分析证实,IUGR、出生体重、恢复出生体重时间、开始肠内营养时间、败血症、NRDS、第1周末氨基酸量是极低出生体质量儿发生EUGR的独立影响因素(P<0.05)。经ROC分析证实,出生体重、恢复出生体重时间、开始肠Objective To observe the extrauterine growth and development of very low birth weight infants and establish a prediction model of extrauterine growth retardation(EUGR).Methods A total of 804 very low birth weight infants admitted to our hospital from January 2019 to January 2021 were included as the research objects and were divided into EUGR group(n=567)and non-EUGR group(n=237)based on the differential diagnosis of EUGR.The basic information of the patients was compared between the two groups during hospitalization,and then the variables with differences were included in the logistic regression analysis.The EUGR was taken as the dependent variable(Y,yes=1,no=0),and other variables like intrauterine growth retardation(IUGR),birth weight,time to recover birth weight,time to start enteral nutrition,sepsis,NRDS and amino acid content at the end of the first week as the independent(X).The risk factors of EUGR in the very low birth weight infants were analyzed,and finally the ROC curve of risk factors was drawn to establish the EUGR prediction model.Results Among the 804 very low birth weight infants,567 cases(70.52%)developed EUGR and they were all included in the EUGR group.Among them,the height of 254 cases was less than 2 standard deviations of the normal infants of the same age and sex at6 months,the body weight of 285 cases had was less than 2 standard deviations of the normal infants of the same age and sex,and the head circumference of 154 cases was less than 2 standard deviations of the normal infants of same age and sex.There were 237 cases(29.48%)diagnosed with no EUGR and then assigned as the non-EUGR group.There were no significant differences in gender,gestational age,discharge weight,length of hospital stay,Apgar score,duration of parenteral nutrition,total oral feeding time,total oral maximum calorie,fat emulsion volume and energy intake at the first and second weekend,amino acid intake at the second weekend,purulent meningitis,BPD and ICH between the two groups(P>0.05).The birth weight and amino acid

关 键 词：极低出生体质量儿 宫外生长发育迟缓 预测模型 危险因素 LOGISTIC回归分析 

分 类 号：R714.5[医药卫生—妇产科学]