攀西地区呼吸窘迫综合征早产儿并发支气管肺发育不良危险因素研究

doi:10.12183/j.scjpm.2021.1241

摘要/Abstract

摘要： 目的分析攀西地区呼吸窘迫综合征早产儿并发支气管肺发育不良（BPD）的危险因素,随访出院1年患儿脑功能及呼吸系统疾病、肺功能情况。方法选择2016年1月至2019年12月在攀枝花市中心医院住院的攀西地区呼吸窘迫综合征早产儿为研究对象,分析其并发BPD的危险因素,采用振幅整合脑电图（aEEG）对患儿脑功能情况进行评价,出院1年后随访患儿呼吸系统疾病发病及肺功能情况。结果 320例呼吸窘迫综合征早产儿有81例患儿并发BPD,发病率为25.31%。经多因素Logistic回归分析结果显示,胎龄<28周（OR=3.443）、出生体重<1 500 g（OR=10.374）、5 min Apgar评分<7分（OR=8.888）、机械通气时间>7 d（OR=9.760）、吸氧浓度≥ 40%（OR=7.354）、新生儿感染（OR=12.872）及产前感染（OR=6.155）均是患儿并发BPD的危险因素。BPD组患儿的背景活动形式及睡眠清醒周期（SWC）均较非BPD组差（均P<0.01）。出院1年期间,BPD组患儿呼吸道感染次数、喘息次数、再入院次数均多于非BPD组（均P<0.01）,2组肺功能指标差异无统计学意义（均P>0.05）。结论胎龄<28周、出生体重<1 500 g、5 min Apgar评分<7分、机械通气时间>7 d、吸氧浓度≥ 40%、新生儿感染及产前感染是攀西地区呼吸窘迫综合征早产儿并发BPD的危险因素;并发BPD会对患儿脑功能发育造成一定影响,且会导致患儿在1岁内出现呼吸道感染及喘息症状,对患儿肺功能的影响还需进一步远期观察。

关键词: 呼吸窘迫综合征, 早产儿, 支气管肺发育不良, 危险因素

Abstract: Objective To analyze the risk factors of bronchopulmonary dysplasia （BPD） in premature infants with respiratory distress syndrome in Panzhihua-Xichang area, and to observe the brain function, respiratory diseases and pulmonary function of the children one year after discharge. Methods Premature infants with respiratory distress syndrome in Panzhihua-Xichang area hospitalized in Panzhihua Central Hospital from January 2016 to December 2019 were selected. The risk factors of BPD were analyzed. The brain function of the children was evaluated by amplitude integrated electroencephalogram （aEEG）. One year after discharge, the incidence of respiratory diseases and pulmonary function were followed up. Results Three hundred and twenty cases of premature infants with respiratory distress syndrome had 81 cases of BPD, the incidence rate was 25.31%. Multivariate Logistic regression analysis showed that gestational age<28 weeks （OR=3.443）, birth weight<1 500 g （OR=10.374）, 5 min Apgar score<7 points （OR=8.888）, mechanical ventilation time>7 days （OR=9.760）, oxygen concentration ≥ 40% （OR=7.354）, neonatal infection （OR=12.872） and prenatal infection （OR=6.155） were the risk factors of BPD in premature infants with respiratory distress syndrome. The background activity and sleep wake cycling （SWC） of children in BPD group were worse than those in non-BPD group （both P<0.01）. One year after discharge, the number of respiratory tract infections, wheezing and readmission in BPD group were more than those in non-BPD group （all P<0.01）. There was no significant difference in pulmonary function index between the two groups （all P>0.05）. Conclusion Gestational age<28 weeks, birth weight<1 500 g, 5 min Apgar score<7 points, mechanical ventilation time>7 days, oxygen concentration≥40%, neonatal infection and prenatal infection are the risk factors of BPD in premature infants with respiratory distress syndrome in Panzhihua-Xichang area. BPD will have a certain impact on the development of children‘s brain function, and will lead to respiratory tract infection and wheezing symptoms within 1 year old. The impact on children’s pulmonary function needs further long-term observation.

Key words: Respiratory distress syndrome, Premature infant, Bronchopulmonary dysplasia, Risk factor

中图分类号:

R174+.6

单良,李娟,杨荣平. 攀西地区呼吸窘迫综合征早产儿并发支气管肺发育不良危险因素研究[J]. 华南预防医学, 2021, 47(10): 1241-1245.

SHAN Liang, LI Juan, YANG Rong-ping. Risk factors and follow-up of bronchopulmonary dysplasia in premature infants with respiratory distress syndrome in Panzhihua-Xichang area[J]. South China Journal of Preventive Medicine, 2021, 47(10): 1241-1245.

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