胎龄≤32周早产儿早期肺动脉高压危险因素及临床结局分析  

Risk factors and clinical outcomes of early-onset pulmonary hypertension in preterm infants with gestational age≤32 weeks

作　　者：尹向云[1] 赵敏 李亮亮[1] 锡洪敏[1] 杨萍[1] 马丽丽[1] 李向红[1] Yin Xiangyun;Zhao Min;Li Liangliang;Xi Hongmin;Yang Ping;Ma Lili;Li Xianghong(Department of Neonatology,the Affiliated Hospital of Qingdao University,Qingdao 266000,China;Department of Pediatrics,Qingdao Women and Children's Hospital,Qingdao 266034,China)

机构地区：[1]青岛大学附属医院新生儿科,青岛266000 [2]青岛市妇女儿童医院小儿内科,青岛266034

出　　处：《中华新生儿科杂志（中英文）》2023年第6期327-331,共5页Chinese Journal of Neonatology

摘　　要：目的探讨胎龄≤32周早产儿早期肺动脉高压(pulmonary hypertension,PH)危险因素及其对预后的影响。方法选择2017年10月至2021年5月青岛大学附属医院新生儿科收治、胎龄≤32周的早产儿进行回顾性研究,根据生后2周内超声心动图结果将患儿分为早期PH组和非PH组,应用SPSS 21.0统计软件分析两组患儿一般情况、并发症及住院结局,采用多因素logistic回归分析胎龄≤32周早产儿发生PH的危险因素。结果共纳入183例患儿,其中早期PH组24例,非PH组159例。早期PH组出生窒息、合并有血流动力学意义的动脉导管未闭(hemodynamically significant patent ductus arteriosus,hsPDA)、生后6 h内吸入氧浓度≥30%、合并晚期PH、重度支气管肺发育不良(bronchopulmonary dysplasia,BPD)、颅内出血的比例高于非PH组,差异有统计学意义(P<0.05)。hsPDA(OR=11.781,95%CI 4.192~33.108)是早产儿发生早期PH的独立危险因素。结论hsPDA是胎龄≤32周早产儿发生早期PH的独立危险因素;胎龄≤32周早期PH早产儿发生颅内出血、晚期PH及重度BPD的风险增加。Objective To study the risk factors and clinical outcomes of early pulmonary hypertension in preterm infants with gestational age(GA)≤32 w.Methods From October 2017 to May 2021,preterm infants with GA≤32 w admitted to NICU of our hospital were retrospectively studied.According to their echocardiography 2 w after birth,the infants were assigned into early-onset pulmonary hypertension(ePH)group and non-PH group.SPSS 21.0 statistical software was used to analyze the general status,complications and clinical outcomes of the two groups.Multiple logistic regression was used to analyze the risk factors of early-onset PH.Results A total of 183 cases were enrolled,including 24 in the ePH group and 159 in the non-PH group.The incidences of birth asphyxia,hemodynamically significant patent ductus arteriosus(hsPDA),FiO2≥30%within 6 h after birth,late-onset PH,severe bronchopulmonary dysplasia(BPD)and intracranial hemorrhage(ICH)in the ePH group were significantly higher than the non-PH group(P<0.05).hsPDA was the independent risk factor for early-onset PH(OR=11.781,95%CI 4.192-33.108).Conclusions Preterm infants with GA≤32 w and early-onset PH are at increased risks of ICH,late-onset PH and severe BPD,hsPDA is the independent risk factor for early-onset PH.

关 键 词：肺动脉高压 支气管肺发育不良 早产儿 

分 类 号：R722.6[医药卫生—儿科]