2020 年第 9 期 第 15 卷

极低及超低出生体质量新生儿重度支气管肺发育不良的危险因素分析

Risk factors of severe bronchopulmonary dysplasia in very low and extremely low birth weight infants

作者：苏莹刘洋刘敏

英文作者：Su Ying Liu Yang Liu Min 

单位：哈尔滨医科大学附属第一医院新生儿科150001

英文单位：Department of Neonatology the First Affiliated Hospital of Harbin Medical University Harbin 150001 China

关键词：支气管肺发育不良；极低出生体质量儿；超低出生体质量儿；危险因素 

英文关键词：Bronchopulmonarydysplasia;Verylowbirthweightinfant;Extremelylowbirthweightinfant;Riskfactors

• 摘要：

• 目的 探究极低出生体质量(VLBW)及超低出生体质量（ELBW)新生儿发生重度支气管肺发育不良(BPD)的病因及其危险因素。方法 回顾性分析2015年1月至2018年12月哈尔滨医科大学附属第一医院诊断为BPD的VLBW/ELBW新生儿216例，其中轻中度BPD患儿128例，重度BPD患儿 88例，分别为轻中度BPD组和重度BPD组。比较2组新生儿相关临床资料及孕期母体情况，采用多因素Logistic回归方法分析重度BPD发生的危险因素。结果 单因素分析显示，重度BPD组出生体质量、胎龄小于轻中度BPD组，产前感染、1 min Apgar评分≤3分、动脉导管未闭(PDA)、新生儿呼吸窘迫综合征、PDA手术、输血＞3次、机械通气时间≥7 d比例均明显高于轻中度BPD组，差异均有统计学意义（均P＜0.05）。多因素Logistic回归分析显示，1 min Apgar评分≤3分(比值比＝5.36，95%置信区间3.28～8.58，P＝0.004)、行PDA手术(比值比＝6.20，95%置信区间2.03～10.37，P＝0.013)、输血＞3次(比值比＝3.06，95%置信区间1.33～6.18，P＝0.028)、机械通气时间≥7 d(比值比＝8.58，95%置信区间2.65～15.59，P＝0.001)是VLBW/ELBW新生儿发生重度BPD的独立危险因素。结论 VLBW/ELBW新生儿发生重度BPD是多种因素作用的结果，1 min Apgar评分≤3分、行PDA手术、输血＞3次、机械通气时间≥7 d是VLBW/ELBW新生儿发生重度BPD的危险因素。

• Objective To explore the risk factors of severe bronchopulmonary dysplasia(BPD) of very low birth weight (VLBW) infants and extremely low birth weight(ELBW) infants. Methods Totally 216 cases of VLBW/ELBW infants diagnosed of BPD in the First Affiliated Hospital of Harbin Medical University from January 2015 to December 2018 were retrospectively analyzed, including 128 cases of mild to moderate BPD and 88 cases of severe BPD. Data of neonates in each group and maternal condition during pregnancy were compared; risk factors of severe BPD were analyzed by Logistic regression. Results Single factor analysis showed that body quality, gestational age, birth in mild to moderate BPD group were lower than those in the severe BPD group(both P＜0.05).The propotion of prenatal infection, 1 min Apgar score≤3, patent ductus arteriosus(PDA), neonatal respiratory distress syndrom, PDA surgery, blood transfusion＞3 times and mechanical ventilation (MV) time≥7 d in mild to moderate BPD group were lower than those in the severe BPD group(all P＜0.05). Multivariate Logistic regression analysis showed that 1 min Apgar score≤3［odds ratio (OR)＝5.36, 95% confidence interval (CI): 3.28-8.58，P＝0.004］, PDA surgery(OR＝6.20, 95% CI: 2.03-10.37，P＝0.013), blood transfusion＞3 times(OR＝3.06, 95% CI: 1.33-6.18，P＝0.028) and MV time≥7 d(OR＝8.58, 95% CI: 2.65-15.59，P＝0.001) were independent risk factors of severe BPD in VLBW/ELBW infants. Conclusions Severe BPD in premature infants with VLBW/ELBW is the result of multiple factors. 1 min Apgar score≤3, PDA surgery, blood transfusion＞3 times and MV time≥7 d are independent risk factors for severe BPD in VLBW/ELBW infants.