早产儿动脉导管未闭的相关危险因素分析

目的 通过对早产新生儿动脉导管未闭(patent ductus arteriosus, PDA)临床资料的回顾性分析,探讨发病的相关因素。方法 纳入笔者医院2012年5月~2014年5月PDA早产新生患儿80例作为实验组,另随机筛选无PDA病症的同期早产新生儿100例作为对照组。对两组新生儿胎龄、体重、孕母患病史、用药史、围生期高危症以及相关指标进行Logistic回归分析,研究早产新生儿PDA的相关危险因素。结果 实验组患儿胎龄与对照组对比,差异无统计学意义(t=0.525,P=0.687);出生体重与对照组对比,差异有统计学意义(t=4.123,P=0.012)。羊水过少(OR=9.67,P=0.010)、羊水粪染(OR=3.50,P=0.019)、宫内缺氧(OR=4.13,P=0.038)、Apgar评分(OR=3.70,P=0.017)、脐带绕颈(OR=4.59,P=0.002)、双胎(OR=3.56,P=0.035)、母孕期感染(OR=11.92,P=0.026)、母孕期糖尿病(OR=8.94,P=0.001)、出生时吸氧治疗(OR=9.41,P=0.003)、HIE(OR=12.12,P=0.014)是早产新生儿PDA发病的危险因素。结论 对新生儿PDA相关危险因素诊断后,能够明确其发病机制,有利于新生儿PDA的临床研究。

Analysis of Risk Factors Associated with Patent Ductus Arteriosus in Preterm Infants

Objective To explore the risk factors of patent ductus arteriosus (PDA) by retrospective analysis of clinical data of PDA in premature neonate. Methods Eighty cases of PDA in premature neonate from May 2012 to May 2014 were selected as experimental group and 100 cases without PDA as control group. The gestational age, weight, motherhood disease history, medication history, perinatal high-risk disease and related factors of the two groups were analyzed by Logistic regression analysis.The risk factors associated with PDA in preterm infants were also analyzed. Results For gestational age, it had no statistical difference between the control group and the experimental group (t=0.525, P=0.687). For birth weight, a significant difference between the two groups(t=4.123,P=0.012). The Logistic regression analysis showed that the risk factors related with the PDA in premature neonate were included oligoamnios(OR=9.67, P=0.010), amniotic infection(OR=3.50, P=0.019), intrauterine hypoxia (OR=4.13, P=0.038), apgar scoring (OR=3.70, P=0.017), cord around neck (OR=4.59, P=0.002), twins (OR=3.56, P=0.035), pregnancy infection (OR=11.92, P=0.026), mother diabetes during pregnancy (OR=8.94, P=0.001), oxygen therapy at the time of birth (OR=9.41, P=0.003), and HIE(OR=12.12, P=0.014). Conclusion Based on diagnosis of risk factors associated with PDA in preterm infants, it can clarify the pathogenesis and useful to PDA clinical studies in newborn.