早产儿脑白质损伤早期相关高危因素  

Early risk factors related to brain white matter damage in premature infants

作　　者：司冉冉 宋红[1] 宋焕清[1] 冯晓霞[1] 刘园园[1] 周川[1] SI Ranran;SONG Hong;SONG Huanqing;FENG Xiaoxia;LIU Yuanyuan;ZHOU Chuan(The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]郑州大学第二附属医院,河南郑州450003

出　　处：《中国实用神经疾病杂志》2022年第1期49-52,共4页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关计划联合共建项目(编号:2018020154);河南省科技厅科技攻关项目(编号:182102310599)。

摘　　要：目的分析早产儿脑白质损伤(WMD)早期相关高危因素。方法选取郑州大学第二附属医院2018-10—2019-05住院的210例早产儿,根据出生后2周内头颅磁共振结果有无异常分为WMD组及对照组。对比2组患儿在围生期的情况及检查结果,进行单因素分析,对单因素分析中的显著因素进行多因素Logistic回归分析。结果210例早产儿中,诊断出WMD共61例,其中轻度30例,中度28例,重度3例,发生率29.04%。单因素分析提示,胎膜早破、脐绕颈、早产、低出生体质量、新生儿窒息、呼吸窘迫、围生期感染、辅助通气2组间比较差异有统计学意义(P<0.05)。Logistic回归分析显示,5 min Apgar评分(OR=2.221,P=0.001)、第1周血管活性药物应用(OR=1.541,P=0.043)及感染(OR=3.612,P=0.02)是独立危险因素。结论多种因素均能影响早产儿WMD的发生,其中窒息史、血流动力学改变及围生期感染是主要的危险因素,临床应针对这些因素,对早产儿采取相应处理措施,以预防WMD的发生。Objective To investigate the risk factors of early white matter damage(WMD)in premature infants.Methods A total of premature infants hospitalized in our hospital from October 2018 to May 2019 were selected and divided into WMD group and control group according to the results of cranial MRI within 2 weeks after birth.The perinatal conditions and examination results of the two groups of children were compared,single factor analysis was carried out,and multivariate Logistic regression analysis was carried out on the significant factors in the single factor.Results Among 210 premature infants,61 cases were diagnosed with WMD,including 30 cases of mild,28 cases of moderate and 3 cases of severe.The incidence rate was 29.04%.Univariate analysis indicated that the difference between the two groups was statistically significant between premature rupture of membranes,umbilical cord around neck,premature delivery,low birth weight,neonatal asphyxia,respiratory distress,perinatal infection,and assisted ventilation(P<0.05).Logistic regression analysis showed that Apgar score(OR=2.221,P=0.001),vasoactive drug application(OR=1.541,P=0.043)and infection(OR=3.612,P=0.02)in the first week were risk factors.Conclusion All kinds of maternal factors,birth factors and fetal factors can affect the occurrence of WMD in premature infants.Asphyxia history,hemodynamic changes and perinatal infection are the main risk factors.

关 键 词：脑白质损伤 早产儿 高危因素 窒息史 血流动力学 感染 

分 类 号：R742[医药卫生—神经病学与精神病学]