双胎早产儿支气管肺发育不良危险因素分析:一项多中心研究  

Risk factors for bronchopulmonary dysplasia in twin preterm infants:a multicenter study

作　　者：樊雨薇 张伊佳 温和梅 晏红 沈蔚 丁月琴 龙运峰 张志钢[8] 李桂芳 姜泓[10] 饶红萍[11] 邱建武 魏贤[13] 张亚昱[14] 曾纪斌 赵常亮[16] 许伟鹏 王凡[18] 员丽[19] 杨秀芳[20] 李薇 林霓阳[22] 陈倩[1] 夏昌顺 钟鑫琪[1] 崔其亮[1] FAN Yu-Wei;ZHANG Yi-Jia;WEN He-Mei;YAN Hong;SHEN Wei;DING Yue-Qin;LONG Yun-Feng;ZHANG Zhi-Gang;LI Gui-Fang;JIANG Hong;RAO Hong-Ping;QIU Jian-Wu;WEI Xian;ZHANG Ya-Yu;ZENG Ji-Bin;ZHAO Chang-Liang;XU Wei-Peng;WANG Fan;YUAN Li;YANG Xiu-Fang;LI Wei;LIN Ni-Yang;CHEN Qian;XIA Chang-Shun;ZHONG Xin-Qi;CUI Qi-Liang(Department of Pediatrics,Third Affiliated Hospital of Guangzhou Medical University/Guangdong Provincial Key Laboratory of Major Obstetric Diseases/Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology/Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine,Guangzhou 510150,China)

机构地区：[1]广州医科大学附属第三医院新生儿科/广东省产科重大疾病重点实验室/广东省妇产疾病临床医学研究中心/粤港澳母胎医学高校联合实验室,广东广州510150 [2]北京大学第三医院儿科,北京100191 [3]四川锦欣妇女儿童医院新生儿科,四川成都610011 [4]贵州医科大学附属医院新生儿科,贵州贵阳550001 [5]厦门大学附属妇女儿童医院新生儿科,福建厦门361003 [6]南方医科大学附属东莞医院新生儿科,广东东莞523000 [7]邵阳学院附属第一医院新生儿科,湖南邵阳422000 [8]广东省第二人民医院新生儿科,广东广州511000 [9]沧州市人民医院新生儿科,河北沧州061000 [10]延安大学附属医院新生儿科,陕西延安716000 [11]惠州市中心人民医院新生儿科,广东惠州516001 [12]汕头大学医学院附属粤北人民医院新生儿科,广东韶关512026 [13]武汉科技大学附属孝感医院新生儿科,湖北孝感432000 [14]内蒙古医科大学附属医院新生儿科,内蒙古呼和浩特010050 [15]汕头大学医学院第二附属医院新生儿科,广东汕头515041 [16]包钢集团第三职工医院新生儿科,内蒙古包头014010 [17]暨南大学附属第一医院新生儿科,广东广州510630 [18]兰州大学第二医院,甘肃兰州730000 [19]新乡市中心医院新生儿科,河南新乡453000 [20]中山市人民医院新生儿科,广东中山528400 [21]东莞市滨海湾中心医院新生儿科,广东东莞523808 [22]汕头大学医学院第一附属医院新生儿科,广东汕头515041

出　　处：《中国当代儿科杂志》2024年第6期611-618,共8页Chinese Journal of Contemporary Pediatrics

基　　金：广州市科技计划项目(2023A03J0382)。

摘　　要：目的 分析胎龄<34周双胎早产儿发生支气管肺发育不良(bronchopulmonary dysplasia,BPD)的危险因素,为临床早期识别双胎早产儿BPD的发生提供依据。方法 回顾性收集全国22家医院2018年1月—2020年12月收治的胎龄<34周双胎早产儿,根据双胎儿患病情况分为三组:两胎均为BPD组、仅一胎为BPD组、两胎均非BPD组,分析双胎早产儿发生BPD的危险因素;并对仅一胎为BPD组患儿进一步分析,组内配对分析双胎早产儿发生BPD的产后危险因素。结果 共纳入胎龄<34周的双胎儿共904对。多因素logistic回归分析中,与两胎均非BPD组相比,双胎出生体重差异>25%是双胎中仅一胎患BPD的危险因素(OR=3.370,95%CI:1.500~7.568,P<0.05),胎龄大是双胎均患BPD的保护因素(P<0.05)。对双胎中仅一胎为BPD组进行组内条件logistic回归分析,提示小于胎龄儿是双胎内个体发生BPD的危险因素(OR=5.017,95%CI:1.040~24.190,P<0.05)。结论 双胎早产儿BPD的发生不仅与胎龄相关,也与双胎出生体重差异、小于胎龄儿密切相关。Objective To investigate the risk factors for bronchopulmonary dysplasia(BPD)in twin preterm infants with a gestational age of<34 weeks,and to provide a basis for early identification of BPD in twin preterm infants in clinical practice.Methods A retrospective analysis was performed for the twin preterm infants with a gestational age of<34 weeks who were admitted to 22 hospitals nationwide from January 2018 to December 2020.According to their conditions,they were divided into group A(both twins had BPD),group B(only one twin had BPD),and group C(neither twin had BPD).The risk factors for BPD in twin preterm infants were analyzed.Further analysis was conducted on group B to investigate the postnatal risk factors for BPD within twins.Results A total of 904 pairs of twins with a gestational age of<34 weeks were included in this study.The multivariate logistic regression analysis showed that compared with group C,birth weight discordance of>25%between the twins was an independent risk factor for BPD in one of the twins(OR=3.370,95%CI:1.500-7.568,P<0.05),and high gestational age at birth was a protective factor against BPD(P<0.05).The conditional logistic regression analysis of group B showed that small-for-gestational-age(SGA)birth was an independent risk factor for BPD in individual twins(OR=5.017,95%CI:1.040-24.190,P<0.05).Conclusions The development of BPD in twin preterm infants is associated with gestational age,birth weight discordance between the twins,and SGA birth.

关 键 词：支气管肺发育不良 危险因素 多中心研究 双胎儿 早产儿 

分 类 号：R722.6[医药卫生—儿科]