不同性别超低出生体重儿临床结局及其死亡危险因素分析  

Effects of gender on clinical outcomes in extremely low birth weight infants and analysis of risk factors of mortality

作　　者：苏志文[1] 梁少珍[1] 黄小霞 吴璜 魏坚伟 贾春宏 吴繁[1] 崔其亮[1] Su Zhiwen;Liang Shaozhen;Huang Xiaoxia;Wu Huang;Wei Jianwei;Jia Chunhong;Wu Fan;Cui Qiliang(Department of Pediatrics,the Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150,China)

机构地区：[1]广州医科大学附属第三医院儿科,广州510150

出　　处：《中华新生儿科杂志（中英文）》2022年第2期138-142,共5页Chinese Journal of Neonatology

基　　金：广东省自然科学基金面上项目(2021A1515011225);广州市科技计划项目(202102010080)。

摘　　要：目的探讨性别对超低出生体重儿(extremely low birth weight infant,ELBWI)临床结局的影响及ELBWI死亡的危险因素。方法选择2011年1月至2020年12月广州医科大学附属第三医院新生儿科收治的ELBWI进行回顾性研究,按性别分为男婴组和女婴组,比较两组患儿主要并发症发生率、存活率和死亡率;根据两组患儿结局再分为存活组和死亡组,采用二分类多因素非条件Logistic回归分析两组ELBWI死亡的危险因素。结果共纳入637例ELBWI,男婴组311例,存活率57.9%(180/311);女婴组326例,存活率57.4%(187/326)。男婴组新生儿呼吸窘迫综合征、支气管肺发育不良、肺出血和重度脑室内出血发生率高于女婴组,差异有统计学意义(P<0.05)。两组ELBWI存活率呈逐年增加趋势(P<0.01);两组存活率、积极救治死亡率和放弃救治死亡率比较差异均无统计学意义(P>0.05)。多因素非条件Logistic回归分析显示,放弃治疗(P<0.01)和肺出血(P<0.05)导致两组ELBWI死亡风险增加。结论男性ELBWI发生新生儿呼吸窘迫综合征、支气管肺发育不良和重度脑室内出血的风险高于女性ELBWI;放弃治疗和肺出血是导致所有ELBWI死亡的共同危险因素。Objective To study the effects of gender on clinical outcomes of extremely low birth weight infants(ELBWI)and to analyze the risk factors of mortality.Methods From January 2011 to December 2020,ELBWI(birth weight<1000 g)admitted to the Neonatology Department of our hospital were retrospectively studied.The infants were assigned into the male group and the female group.Incidences of major complications,survival rate and mortality rate were compared between the two groups.The infants were also assigned into survival group and death group according to their clinical outcomes.Binary multivariate unconditional Logistic regression was used to analyze the risk factors of mortality in ELBWI.Results A total of 637 ELBWI cases were included.311 cases were in the male group with a survival rate of 57.9%(180/311)and 326 cases were in the female group with a survival rate of 57.4%(187/326).The incidences of neonatal respiratory distress syndrome(RDS),bronchopulmonary dysplasia(BPD),pulmonary hemorrhage and severe intraventricular hemorrhage(IVH)in the male group were significantly higher than the female group(P<0.05).Significant increases of survival rate existed for both groups year by year(P<0.01).No significant differences existed in survival rate,mortality rate of infants receiving proactive treatment and mortality rate of infants withdrawing treatment between the two groups(P>0.05).Multivariate unconditional Logistic regression analysis showed that withdrawing treatment(P<0.01)and pulmonary hemorrhage(P<0.05)were associated with increased risks of mortality.Conclusions Male ELBWI have higher risks of RDS,BPD and severe IVH than female ELBWI.Withdrawing treatment and pulmonary hemorrhage are common risk factors of mortality for both male and female ELBWI.

关 键 词：性别因素 婴儿 超低出生体重 并发症 存活率 死亡率 

分 类 号：R722.6[医药卫生—儿科]