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目的探讨早产儿支气管肺发育不良(BPD)的发生率及危险因素。方法应用前瞻性队列研究的方法,对我院产科2009年1月至2010年6月出生的所有活产早产儿进行研究,统计BPD发生率,并分析相关危险因素。结果 (1)共有425例早产儿入组研究,其中男266例,女159例;胎龄(33.9±2.4)周(26～36周);出生体重(2038±660)g(770～3150g),其中极低出生体重儿85例,超低出生体重儿7例。发生BPD45例,发生率10.6%,死亡(包括自动出院撤机后死亡)7例,BPD病死率15.6%。BPD患儿胎龄≤32周36例(80.0%),出生体重<1500g29例(64.4%)。(2)多因素Logistic回归分析显示胎龄<30周(OR=3.10)、出生体重<1500g(OR=2.29)、感染性肺炎(OR=2.74)、动脉导管未闭(OR=2.12)、机械通气(OR=9.57)、H2受体抑制剂(OR=1.36)、应用碳青霉烯类抗生素>4周(OR=2.59)是BPD发病的独立危险因素(P均<0.05)。结论早产儿发生BPD的独立危险因素较多,需要综合防治才能有效控制BPD的发生。
Objective To investigate the incidence and risk factors of bronchopulmonary dysplasia (BPD) in preterm infants. Methods By prospective cohort study, all live born premature infants born from January 2009 to June 2010 in our hospital were studied. The incidence of BPD was analyzed and the related risk factors were analyzed. Results A total of 425 preterm infants were enrolled in the study, including 266 males and 159 females; gestational age (33.9 ± 2.4) weeks (26-36 weeks); birth weight (2038 ± 660) g , Including 85 cases of very low birth weight children and 7 cases of ultra-low birth weight children. BPD occurred in 45 cases, the incidence of 10.6%, death (including autopsy withdrawal after weaning) in 7 cases, BPD fatality rate of 15.6%. BPD children with gestational age ≤ 32 weeks 36 cases (80.0%), birth weight <1500g29 cases (64.4%). (2) Multivariate logistic regression analysis showed that gestational age <30 weeks (OR = 3.10), birth weight <1500g (OR = 2.29), infectious pneumonia (OR = 2.74), patent ductus arteriosus (OR = 2.12) Ventilation (OR = 9.57), H2 receptor inhibitor (OR = 1.36), carbapenem antibiotics for more than 4 weeks (OR = 2.59) were independent risk factors for BPD (all P <0.05). Conclusion There are more independent risk factors for BPD in preterm infants. Comprehensive prevention and treatment are needed to effectively control BPD.