超/极低出生体重儿嗜酸性粒细胞增多症与支气管肺发育不良的临床相关性分析  

Clinical correlation analysis of eosinophilia and bronchopulmonary dysplasia in extremely/very low birth weight infants

作　　者：朱晶文 何玺玉 郭明 李玉蕊 张雪峰 Zhu Jingwen;He Xiyu;Guo Ming;Li Yurui;Zhang Xuefeng(Department of Pediatrics,the Fifth Medical Center of Chinese PLA General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院第五医学中心儿科,北京100039

出　　处：《发育医学电子杂志》2024年第4期271-277,共7页Journal of Developmental Medicine (Electronic Version)

摘　　要：目的探讨发生不同程度嗜酸性粒细胞增多症的超低出生体重儿(extremely low birth weight infants,ELBW)和极低出生体重儿(very low birth weight infants,VLBW)的临床特点,以及嗜酸性粒细胞增多症与支气管肺发育不良(bronchopulmonary dysplasia,BPD)的相关性。方法回顾性分析2019年1月至2022年12月解放军总医院第五医学中心儿科收治的147例ELBW及VLBW患儿的临床资料。根据嗜酸性粒细胞计数升高程度进行分组:正常组(嗜酸性粒细胞计数<0.7×10^(9)/L,n=43),轻度升高组[嗜酸性粒细胞计数为(0.7~0.9)×10^(9)/L,n=39]、中重度升高组(嗜酸性粒细胞计数≥1.0×10^(9)/L,n=65),比较各组围产期资料以及出生后相关疾病的发生率。根据患儿是否患有BPD以及BPD的严重程度分为无BPD组(n=81),轻度BPD组(n=46),中重度BPD组(n=20),比较3组患儿之间嗜酸性粒细胞计数的差异。统计学方法包括t检验、方差分析、秩和检验、χ^(2)检验、Fisher确切概率法,以及单因素和多因素Logistic回归分析、受试者工作特征(receiver operating characteristic,ROC)曲线。结果嗜酸性粒细胞增多症的发病率为70.7%(104/147),其中轻度升高26.5%(39/147),中重度升高44.2%(65/147)。中重度升高组和轻度升高组胎龄均小于正常组,差异均有统计学意义(P值均<0.05)。嗜酸性粒细胞计数轻度、中重度升高组中败血症、Ⅱ度以上呼吸窘迫综合征(respiratory distress syndrome,RDS)、BPD、血液输注的发生率明显高于正常组;中重度升高组患儿的BPD发生率高于轻度升高组;轻度、中重度升高组无创呼吸机应用时间均长于正常组,差异均有统计学意义(P值均<0.05)。无BPD组和BPD组患儿的胎龄、败血症的发生率以及嗜酸性粒细胞增多症、呼吸机应用天数、血液输注比较,差异均有统计学意义(P值均<0.05)。多因素Logistic回归分析结果显示,胎龄、嗜酸性粒细胞增多症、呼吸机应用天数、血液输注、�Objective To investigate the clinical characteristics of extremely low birth weight infants(ELBW)and very low birth weight infants(VLBW)with different degrees of eosinophilia,and analyze the correlation between eosinophilia and bronchopulmonary dysplasia(BPD).Method The clinical data of 147 ELBW and VLBW infants admitted to the Department of Pediatrics,the Fifth Medical Center of Chinese PLA General Hospital from January 2019 to December 2022 were retrospectively analyzed.The infants were divided into normal group(eosinophils<0.7×10^(9)/L,n=43),mild elevation group[eosinophils was(0.7-0.9)×10^(9)/L,n=39]and moderate to severe elevation group(eosinophils≥1.0×10^(9)/L,n=65)according to the degree of elevation in eosinophils.Perinatal data and incidence of postnatal related diseases were compared among all groups.According to whether the infants had BPD and the severity of BPD,they were divided into non-BPD group(n=81),mild BPD group(n=46)and moderate to severe BPD group(n=20),and the differences in eosinophils among the three groups were compared.Statistical methods performed by t-test,analysis of variance,rank sum test,χ^(2)test,Fisher exact probability method,univariate and multivariate Logistic regression analysis and receiver operating characteristic(ROC)curve.Result The incidence of eosinophilia was 70.7%(104/147),with a mild elevation of 26.5%(39/147),a moderate to severe elevation of 44.2%(65/147).The gestational age of moderate and severe elevation group and mild elevation group was lower than that in the normal group,and the differences were statistically significant(all P<0.05).The incidence of septicemia,respiratory distress syndrome(RDS)above degreeⅡ,BPD and blood transfusion in mild elevation group and moderate to severe elevation group were significantly higher than those in the normal group.The incidence of BPD in the moderate to severe elevation group was higher than that in the mild elevation group.The application time of non-invasive ventilator in mild elevation group and moderate to sever

关 键 词：超低出生体重儿 极低出生体重儿 嗜酸粒细胞增多症 支气管肺发育不良 败血症 

分 类 号：R722.1[医药卫生—儿科]