关于极早产儿hsPDA影响因素的多中心研究  

Multicenter Study on Factors Influencing hsPDA in Extremely Preterm Infants

作　　者：刘洋[1] 李桂芳[2] 丁艳洁[3] 于永慧 

机构地区：[1]青岛大学医学院,山东 青岛 [2]泰安市中心医院新生儿科,山东 泰安 [3]青岛大学医学院附属烟台毓璜顶医院新生儿科,山东 烟台 [4]山东第一医科大学附属省立医院新生儿科,山东 济南

出　　处：《临床医学进展》2024年第5期950-958,共9页Advances in Clinical Medicine

摘　　要：研究目的:本论文旨在研究极早产儿有血流动力学意义的动脉导管未闭(haemodynamically significant patent ductus arteriosus, hsPDA)的发生率、临床特征以及生命早期影响其发生的因素。研究方法:我们采用了回顾性研究设计,纳入SNN数据库2019.01.01至2023.08.01收录的9865个极早产儿病例,选择了符合特定标准的极早产儿,探讨hsPDA的发生率及影响hsPDA发生的相关因素。我们收集的数据包括人口学特征(如性别、出生体重、母亲的健康状况和孕期史等)和临床情况(如分娩时情况、PDA的存在及严重程度等)。我们将病例划分为hsPDA组和非hsPDA组,以便更深入地分析两组之间的发生率、临床特征及人口学特征的差异。结果:通过本研究的分析,出生胎龄越小、体重越低,hsPDA的发生率越高。而多胎妊娠、非自然受孕、母亲合并糖尿病或合并甲状腺功能减退、分娩时气管插管、生后长时间呼吸支持,这些因素可能与hsPDA的发生有关。结论:极早产儿生命早期的差异可能影响生后hsPDA的发生。我们的研究结果可能为临床医生早期诊断、实施精准治疗提供依据。Objective: This study aims to examine the incidence, clinical presentations, and contributing factors of hemodynamically significant patent ductus arteriosus (hsPDA) among extremely preterm infants during their initial days of life. Methods: Utilizing a retrospective cohort design, we reviewed records of 9865 preterm infants from the SNN database spanning January 1, 2019, to August 1, 2023. Infants meeting specific inclusion criteria were selected to identify correlates of hsPDA onset. Demographic variables (gender, birth weight, maternal health, and obstetric history) and clinical data (perinatal conditions, PDA presence, and severity) were collected. Cases were dichotomized into hsPDA and non-hsPDA categories for a nuanced comparison of incidence rates, clinical profiles, and demographic traits. Results: Our analyses revealed that reduced gestational age and birth weight are positively correlated with an increased incidence of hsPDA. Furthermore, our findings suggest that twin/multiple births, assisted reproductive technologies, maternal medical conditions (diabetes, hypothyroidism), intubation at delivery, and extended postnatal respiratory support are potentially linked to the development of hsPDA. Conclusion: The disparities in the early life of extremely preterm infants may affect the postnatal occurrence of hsPDA. These findings could offer clinicians a foundation for early diagnosis and targeted intervention strategies.

关 键 词：极早产儿 有血流动力学意义的动脉导管未闭 影响因素 早期诊断 

分 类 号：R71[医药卫生—妇产科学]