早产儿脑室周围白质软化的相关因素研究

摘要：目的　分析导致早产儿脑损伤的相关危险因素。方法　以2006年1月至2009年6月入住安徽省立儿童医院新生儿科的443例早产儿为研究对象，分为脑室周围白质软化（PVL）组（125例）与无PVL组（318例），按PVL级别分为非囊性PVL组（116例）和囊性PVL组（9例），采用头颅超声诊断技术早期诊断早产儿PVL，用多因素分析影响PVL及其不同级别的高危因素。 结果　单因素分析显示：胎龄、出生体重、分娩方式、低体温、生后感染、呼吸暂停、血糖、心肌酶谱、C-反应蛋白（CRP）和血清白蛋白在PVL组和无PVL组之间差异有统计学意义（P < 0.05或P < 0.01）。多因素Logistic回归分析显示：出生体重低、母亲低剖宫产率、生后感染及血清白蛋白和心肌酶谱水平高是早产儿发生PVL的危险因素，另外，生后感染是发生囊性PVL的危险因素。结论　出生体重低、母亲低剖宫产率、生后感染及血清白蛋白和心肌酶谱高是早产儿发生PVL的危险因素，另外，生后感染的早产儿发生囊性PVL的风险较高。

Study on related factors of periventricular leukomalacia among preterm infants.

Abstract:Objective　Using the skill of head ultrasound to make an early diagnosis for preterm infants with periventricular leukomalacia（PVL），analyze some related risk factors which may result in PVL. Methods　Between Jan. 2006 and Jun. 2009，443 preterm infants were chosen， who were born in Anhui Provincial Children’s Hospital. All subjects were divided into PVL group（125） and non PVL group（318），non Cystic PVL group（116） and Cystic PVL group（9） by different grades of PVL. The factors of PVL were analyzed by Backward Stepwise Logistic regression. Results　Univariate factor analysis showed： the difference was significant （P < 0.05 or P < 0.01）among gestational age， birth weight， delivery pattern， hypothermia， apnea， blood sugar， myocardial enzyme， postnatal infection， cAMP receptor protein and albumin between PVL group and non PVL group. Multiple factors Logistic regression showed： low birth weight and incidence of uterine-incision delivery， postnatal infection， higher level of myocardial enzyme and albumin were risk factors of PVL， and postnatal infection was risk factor of cystic PVL. Conclusion　Low birth weight， spontaneous delivery， postnatal infection and high levels of albumin and myocardial enzyme are risk factors of PVL. Preterm infants with postnatal infection have higher incidence of cystic PVL.