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目的:对早产儿心脏超声及头颅影像学筛查结果进行分析,探讨早产儿不同类型先天性心脏病及颅内出血的发生率及部分相关因素。方法:对北京大学人民医院2008年1月～2010年10月收治的396例早产儿进行回顾性研究,分析早产儿心脏超声及头颅影像学筛查结果,及其与胎龄、性别的相关性。结果:北京大学人民医院396例早产儿中卵圆孔未闭发生率为72.0%(285/396),动脉导管未闭发生率为15.7%(62/396),房间隔缺损发生率为2.3%(9/396),室间隔缺损发生率为0.5%(2/396),瓣膜病变发生率为2.0%(8/396)。但早期早产儿和晚期早产儿及不同性别早产儿之间上述不同类型心脏结构异常发生率并无统计学差异。396例早产儿中硬膜下出血发生率为2.8%(11/396),蛛网膜下腔出血发生率为12.9%(51/396),脑实质出血发生率为6.8%(27/396),脑室内出血发生率0.3%(1/396)。头颅影像学筛查结果显示男性早产儿硬膜下出血发生率较女性早产儿高(P<0.05),而男性早产儿脑实质出血发生率则较女性早产儿低(P<0.05)。但早期早产儿和晚期早产儿之间上述不同类型颅内出血发生率并无统计学差异。结论:卵圆孔未闭、动脉导管未闭、房间隔缺损分列早产儿心脏结构异常前三位,蛛网膜下腔出血、脑实质出血、硬膜下出血分列早产儿颅内出血前三位。且部分类型颅内出血的发生率与性别相关。
OBJECTIVE: To analyze the results of echocardiography and cephalic imaging in preterm infants to explore the prevalence and related factors of different types of congenital heart disease and intracranial hemorrhage in premature infants. Methods: A retrospective study was conducted on 396 preterm infants admitted to Peking University People’s Hospital from January 2008 to October 2010. The results of echocardiographic and cephalometric examination of preterm infants and their correlation with gestational age and gender were analyzed . Results: The incidence of foramen ovale in 396 premature infants of Peking University People’s Hospital was 72.0% (285/396), the incidence of patent ductus arteriosus was 15.7% (62/396), the incidence of atrial septal defect was 2.3% (9/396). The incidence of ventricular septal defect was 0.5% (2/396) and the incidence of valvular disease was 2.0% (8/396). However, there was no significant difference in the incidence of abnormal heart structure between the early preterm and the late preterm infants and the different gender preterm infants. In 396 premature infants, the incidence of subdural hemorrhage was 2.8% (11/396), subarachnoid hemorrhage was 12.9% (51/396), and the incidence of parenchymal hemorrhage was 6.8% (27/396) The incidence of intraventricular hemorrhage 0.3% (1/396). The results of cranial imaging screening showed that the incidence of subdural hemorrhage in preterm infants was higher than that of female preterm infants (P <0.05), while the incidence of cerebral parenchymal hemorrhage in preterm infants was lower than that of female preterm infants (P <0.05). However, there was no significant difference in the incidence of intracranial hemorrhage among the above types of early preterm and late preterm infants. Conclusions: Foveal patent foramen ovale, patent ductus arteriosus, atrial septal defect are listed in the top three of the cardiac structural abnormalities in preterm infants, subarachnoid hemorrhage, intraparenchymal hemorrhage, subdural hemorrhage . And some types of intracranial hemorrhage incidence and gender related.