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目的探讨不同严重程度支气管肺发育不良(BPD)早产儿的临床特点,了解BPD发生及严重程度的相关因素。方法选择2009年1月至2012年12月收住本院新生儿科诊断为BPD的早产儿,按BPD严重程度进行分组,比较不同程度BPD患儿性别、胎龄、窒息、呼吸窘迫综合征、动脉导管未闭、肺表面活性物质治疗、产前激素、生后静脉激素等临床资料及机械通气治疗情况。结果研究期间共收治早产儿1 332例,其中胎龄<32周182例,发生BPD 34例,发生率18.7%;≥32周1 150例,发生BPD 17例,发生率1.5%,差异有统计学意义(χ~2=126.289,P<0.001)。51例BPD患儿中轻度14例,中、重度37例。单因素分析显示,中、重度患儿与轻度患儿比较,男婴比例更高(83.8%比50.0%)、总通气时间更长[(47.6±15.6)天比(37.1±11.4)天],差异有统计学意义(P<0.05);多因素Logistic回归分析显示,总通气时间是中、重度BPD的危险因素(OR=1.167,95%CI 1.027~1.327),败血症是中、重度BPD的保护因素(OR=0.034,95%CI0.002~0.517)。结论胎龄<32周早产儿BPD发生率更高,中、重度BPD患儿男婴比例更高;总通气时间是中、重度BPD的危险因素,败血症是中、重度BPD的保护因素。
Objective To investigate the clinical features of preterm infants with different severity of bronchopulmonary dysplasia (BPD) and to understand the related factors of the occurrence and severity of BPD. Methods From January 2009 to December 2012, our hospital received neonatal pediatric diagnosis of BPD in preterm infants, according to the severity of BPD were grouped to compare the different levels of BPD children sex, gestational age, asphyxia, respiratory distress syndrome, arterial Catheter patent, pulmonary surfactant treatment, prenatal hormones, postpartum venous hormone and other clinical data and mechanical ventilation treatment. Results A total of 1 332 preterm infants were enrolled during the study period, including 182 cases of gestational age <32 weeks, 34 cases of BPD, the incidence rate was 18.7%; 11 150 cases of ≥32 weeks, BPD occurred in 17 cases, the incidence was 1.5% Significance (χ ~ 2 = 126.289, P <0.001). Fifty-one children with BPD were mild in 14, moderate and severe in 37. Univariate analysis showed that the proportion of male infants was higher (83.8% vs 50.0%) and the total duration of ventilation was longer in moderate and severe children than in mild children (47.6 ± 15.6 vs. 37.1 ± 11.4 days) , The difference was statistically significant (P <0.05). The multivariate logistic regression analysis showed that the total ventilation time was the risk factor of moderate and severe BPD (OR = 1.167,95% CI 1.027-1.327). Sepsis was moderate and severe BPD Protection factor (OR = 0.034, 95% CI0.002 ~ 0.517). Conclusions The incidence of BPD is higher in preterm infants of gestational age <32 weeks, and higher in boys with moderate and severe BPD. The total duration of ventilatory time is the risk factor of moderate and severe BPD. Sepsis is the protective factor of moderate and severe BPD.