影响早产儿贫血的相关因素分析

目的 探讨影响和加重早产儿贫血的因素.方法 选择2012年1月至2013年6月在我院新生儿科住院期间出现贫血的早产儿,按不同胎龄、出生体重、出生时基础血红蛋白（Hb）值、有无机械通气进行分组,分别比较各组贫血出现时间和住院期间Hb最低值.结果 胎龄＜32周、出生体重＜1500 g的早产儿,贫血出现时间分别为（12.9±5.0）天、（12.5±4.1）天,Hb最低值分别为（94.3±14.1）g/L、（90.0±10.3）g/L,随着胎龄和出生体重增加,贫血出现时间延迟,程度减轻（P均＜0.05）.出生时基础Hb值≤145 g/L的早产儿,贫血出现时间为（7.1±1.4）天,Hb平均值为（100.0±9.2）g/L,与出生时基础Hb值＞145 g/L的早产儿比较,贫血时间早（P＜0.05）.需机械通气者贫血出现时间为（10.5±3.4）天,Hb平均值为（88.7±9.5）g/L,与非机械通气组比较,贫血出现时间早,程度重（P＜0.05）.多元线性回归分析显示,胎龄、出生体重和基础Hb值为早产儿贫血出现时间的影响因素,胎龄和基础Hb值是影响最低Hb值的因素.结论 胎龄越小,出生体重越低,贫血出现时间越早,贫血程度越重.基础Hb值越低,贫血出现越早.需机械通气者因病情重,受多种因素影响可加重早产儿贫血.

Analysis of the related factors affecting the premature anemia

Objective To investigate the factors that are associated with anemia of prematurity.Methods The research project recruited babies （n =168） admitted to Children＇s Hospital of Hebei Province from Jan.2012 to Jun.2013.Preterm infants with anemia were divided into groups according to gestational age,birth weight,hemoglobin （Hb） at birth and mechanical ventilation requirement.The average time for onset of anemia and the lowest Hb value were compared.Results The average time for onset of anemia in preterm infants whose gestational age were 〈32 weeks and birth weight were 〈 1500 g,were （12.9 ± 5.0） d and （12.5 ± 4.1） d respectively.Lowest Hb values were （94.3 ± 14.1） g/L and （90.0 ± 10.3） g/L.When gestational age and birth weight increased,the severity of anemia lessened （P 〈0.05）.The average time for onset of anemia in preterm infants whose initial Hb values were ≤145 g/L was （7.1 ± 1.4）d [the average Hb value was （1030.0 ±9.2） g/L].Compared with preterm infants whose initial Hb values were 〉 145 g/L,the time of anemia onset was earlier （P 〈 0.05）.The average time for onset of anemia in preterm infants who used mechanical ventilation was （10.5 ± 3.4）d,and the average Hb value was （88.7 ± 9.5）g/L.Compared with the non mechanical ventilation group,the time of anemia onset was earlier,and there was an increased severity of anemia （P 〈 0.05）.Conclusions Gestational age and birth weight were associated with anemia of prematurity.The average time for onset of anemia was earlier and the severity of anemia was greater when the gestational age and the birth weight decreased.The average time for onset of anemia was associated with initial Hb values.Mechanical ventilation was associated with increased severity of anemia due to multifactorial causes.