早产儿宫外生长迟缓与胰岛素样生长因子

目的:讨论胰岛素生长因子与早产儿宫外生长迟缓的关系。方法:随机选择我院2011年1月至2011年8月的100例早产儿,每名早产儿的一般资料比较无明显差异,无统计学意义(P>0.05),在出生后第8、15天用酶联免疫法测定血清中的胰岛素样生长因子,同时对胎儿的体重的增长速度,Kaup指数进行监测。结果:胰岛素样生长因子低的早产儿的体重及Kaup指数要低于胰岛素样生长因子高的早产儿(P<0.05),具有统计意义。结论:胰岛素样生长因子与早产儿宫外生长迟缓有密切联系。     

早产和足月新生儿血清瘦素与出生体重及胰岛素关系分析

目的研究早产和足月新生儿血清瘦素与出生体重及胰岛素关系,探讨在早产和足月新生儿中是否存在脂肪-胰岛素内分泌轴。方法共收集264例早产和足月新生儿,按胎龄进行分组,并进行出生测量,于生后第3天采血做餐前血糖、胰岛素及瘦素检查。结果足月儿血清瘦素浓度显著高于早产儿,瘦素浓度与胎龄的关系按非线性模式增加,胎龄34周以后,瘦素浓度增加明显加快。在>32周的新生儿中,血清瘦素浓度与出生体重及胰岛素呈正相关关系(r=0.240,0.227,P<0.05),在胎龄≥37周的新生儿中,瘦素不仅与出生体重及胰岛素呈正相关(r=0.198,0.253,P<0.05),还与胰岛素/血糖呈正相关(r=0.206,P<0.05),在<32周的新生儿中,未发现上述关系。结论胎龄>32周的新生儿体内可能已开始存在脂肪-胰岛素内分泌轴。     

早产儿瘦素质量浓度与早期静脉营养及生长发育相关性探讨

目的探讨瘦素质量浓度与早期静脉营养及生长发育的关系。方法新疆医科大学第一 附属医院新生儿科于2005 01—2006 02，将收治的86例早产适于胎龄儿用随机数字表法分为观察组(早期微量喂养同时辅助胃肠外营养组)45 例和对照组(单纯早期微量喂养组)47例，分别测定脐血及第7天血清瘦素质量浓度，同时监测营养状况和生长发育指标，并作对比分析。结果 (1)观察组与对照组脐血瘦素质量浓度分别为(4.6±3.7)ng/mL、(4.8±2.2)ng/mL，生后第7天两组瘦素质量浓度分别为(4.3±2.2)ng/mL、(3.1 ±1.7)ng/mL。对照组第7天血清瘦素质量浓度明显低于脐血(P<0.05)，而观察组其差异无统计学意义(P>0.05)。(2)脐血瘦素质量浓度与出生体 重、胎龄成正相关(r=0.56、r=0.67)。(3)观察组第7天热卡及蛋白质摄入量、血清瘦素质量浓度、皮褶厚度变化值与对照组相比，差异有统计 学意义(P<0.05)。结论对早产儿应尽早喂养，同时需要胃肠外营养作为肠内营养的补充。瘦素可作为新生儿营养效果判定的实验室指标之一。     

早产儿视网膜病激光治疗及相关危险因素研究

目的探讨早产儿视网膜病(retinopathy of prematurity,ROP)激光治疗效果及该病发生的相关危险因素。方法以35例因各种疾病住院治疗的早产儿为观察对象。对性别、胎龄、出生体重、Apgar评分、出生时及出生后缺氧、贫血、黄疸、感染、母亲年龄及孕期情况进行观察并进行头颅B超检查。用χ2检验、Fisher确切概率法、t检验以及Logistic回归做统计分析,评价激光治疗的疗效,分析早产儿视网膜病发生的危险因素。结果35例患病早产儿中有27例发生早产儿视网膜病,发生率77.1%。25例患儿接受激光治疗,并分别于术后7～14d及3个月进行随访,治愈率分别为74.1%和92.6%。ROP组出生体重(1144.81±284.83)g,明显小于未发病组(8例)出生体重(1743.75±423.79)g,P<0.01;ROP组胎龄(29.04±2.70)周,明显小于未发病组胎龄(32.50±1.85)周,P<0.01。且出生体重越低,胎龄越小,ROP发生率越高,P<0.01。经Fisher确切概率法检验显示出生后缺氧、贫血等因素在ROP发病组与未发病组差异有统计学意义(P<0.05)。结论早产儿视网膜病在伴随各种疾病的早产儿中发生率较常见患病率高,其发病与缺氧、贫血、胎龄和出生体重有关。对患病早产儿进行激光治疗可获得较好的疗效,采取早监测、早发现、早治疗,则可获得较好的预后。     

早期早产儿促红细胞生成素的动态变化及相关性分析

目的观察促红细胞生成素(EPO)在早期早产儿的动态变化及相关性分析。方法 36例出生胎龄35周、体质量2500g的早产儿根据发育商程度分为3组,正常组21例,轻度异常组10例,迟缓组5例。其中极低出生体重儿(1500g)19例,出生低体重儿(1500～2500g)17例。分别抽取脐血、出生7、14d桡动脉血2mL,用ELISA法进行检测EPO。结果 (1)早产儿胎龄、出生体质量、出生时血红蛋白、出生时红细胞计数与脐血EPO水平无明显线性相关关系;(2)体质量1500g与1500～2500g早产儿EPO脐血、出生7、14d水平变化不大,差异无统计学意义(P0.05)。(3)迟缓组、轻度异常组、正常组脐血EPO水平变化差异无统计学意义(P0.05)。出生7d迟缓组EPO水平明显高于正常组,差异有统计学意义(P0.01),但与轻度异常组比较差异无统计学意义(P0.05)。出生14d迟缓组EPO水平均明显高于正常组和轻度异常组,差异有统计学意义(P0.05,0.01)。结论早产儿脐血EPO水平可能是独立于胎龄、出生体质量、出生时血红蛋白、出生时红细胞计数的细胞因子。早产儿出生7、14d持续的血浆EPO水平升高,可能与早产儿神经发育迟缓有关。     

新生儿重症监护病房早产儿脑损伤危险因素分析

目的 调查新生儿重症监护病房(NlCU)早产儿脑损伤的发生情况并分析其高危因素.方法将2006年2月1日至2007年1月31日入住复旦大学附属儿科医院NICU的胎龄≤34周或出生体重≤2000 g的早产儿纳入研究.应用超声诊断仪对早产儿进行系列床边头颅B超检查.同时收集临床资料,分析早产儿脑损伤的发生率,用Logistic回归模型分析其危险因素. 结果 (1)328例早产儿完成系列头颅B超检查,141例(43.0%)发生脑室内出血(IVH),其中轻度101例,重度40例.9.8%的患儿(32/328)发生脑白质损伤(WMD).13.4%的患儿(44/328)发生持续脑室扩大.10.7%的患儿(35/328)在生后初次头颅B超筛查时即发现有颅内囊肿形成.(2)IVH组和WMD组患儿的出生体重和胎龄较未发病组低,差异有统计学意义(P<0.05).(3)Logistic回归分析提示出生体重、感染、小于胎龄儿、机械通气是IVH的独立危险因素.出生体重是WMD的独立危险因素. 结论 NICU早产儿脑损伤发生率较高.出生体重、感染、小于胎龄儿、机械通气是IVH的独立危险因素.出生体重是WMD的独立危险因素.     

宫外生长发育迟缓与营养

宫外生长发育迟缓(extrauterine growth retardation,EUGR)是相对宫内生长发育迟缓而言.妊娠晚期和出生早期是一生中体格增长最迅速的时期,极低出生体重儿(very low birth weight infant,VLBWI)和超低出生体重儿(extremely low birth weight infant,ELBWI)由于提前出生,失去了宫内营养积累和快速生长的关键时期,加之生后早期各种因素的影响,其生长发育往往落后于宫内生长发育的速率,形成EUGR.EUGR多定义为出院时体重小于同胎龄体重的第10百分位数.EUGR 是VLBWI和ELBWI早产儿的一种常见现象.     

早产儿视网膜病相关危险因素的探讨

目的　探讨早产儿视网膜病 (ROP)发生的相关危险因素。　方法　以 13 5例早产儿患儿为研究对象 ,对胎龄、性别、出生体重、吸氧时间、吸氧浓度、肺透明膜病、Apgar评分、颅内出血、支气管肺发育不良、反复呼吸暂停、动脉导管开放、眼底等进行检查。同时用单因素 χ2 检验和多因素logistic回归分析筛选和判定早产儿ROP发生的危险因素。　结果　 13 5例中有 2 8例合并ROP ,占2 0 .7% (2 8/ 13 5)。经logistic回归分析 ,发现吸氧浓度、吸氧时间、出生体重、胎龄与早产儿ROP的发生有显著相关性 (r =0 .451,P <0 .0 5)。　结论　吸氧浓度、吸氧时间、出生体重、胎龄为早产儿ROP发生的重要危险因素 ,建议对所有早产儿常规行眼底检查 ,重视并针对其危险因素加以预防     

孕妇肥胖对婴儿体格发育和瘦素质量浓度的影响

目的探讨孕妇肥胖对婴儿体格发育和瘦素质量浓度的影响。 方法武汉大学人民医院儿科于2002年1月至2003年6月选择肥胖孕妇和正常体重孕妇各80例,比较她们的子代在出生后及满1岁时的体重、身高和血清瘦素质量浓度；瘦素检测使用双抗体夹心ELISA法。 结果符合检测数据统计条件的肥胖组为53例，正常组49例。(1)肥胖孕妇的瘦素质量浓度明显高于正常体重孕妇(P<0.01)；(2)肥胖孕妇组子代出生体重和脐血瘦素质量浓度明显高于正常组(P<0.01)；(3)肥胖孕妇组子代1岁时体重和血清瘦素质量浓度明显高于正常组子代(P<0.05)。 结论孕妇肥胖对婴儿的体重和瘦素质量浓度有明显的影响，此影响对子代以后的生长发育和瘦素质量浓度是否继续存在还需要进一步的研究。     

不同胎龄和出生体重早产儿的并发症及其结局探讨

目的 探讨早产儿并发症的发生和结局与胎龄、出生体重的关系.方法 对我院1995年1月至2004年12月共1882例住院早产儿临床资料进行回顾性分析.结果 早产儿死亡率3.3%(62/1882),随胎龄和出生体重的增加,死亡率下降.胎龄《32周者肺透明膜病死亡率高.早产儿并发症发生率为49.5%(932/1882),并发症主要发生于胎龄《32周或出生体重《1500 g的极低出生体重儿,以肺透明膜病、窒息和呼吸暂停为主.胎龄32周以上或出生体重》1500 g的早产儿并发症发生率降低.结论 加强孕期管理降低极低出生体重儿的发生率,对可能早产者积极应用肾上腺皮质激素促胎肺成熟、出生后采取正确有效的复苏抢救措施、预防窒息发生,及早补充肺表面活性物质,将有助于降低早产儿并发婴儿症发病率和死亡率,改善其预后.     

Adjustable fortification of human milk fed to preterm infants: does it make a difference?

BACKGROUND: Inadequate nutrition leading to growth failure is common among premature infants. Although fortified breast milk (breast milk plus commercially prepared fortifier) is the preferred feeding, nutrient intakes achieved with fortified breast milk fall short of meeting nutrient needs. This is mainly due to inadequate protein content of fortifiers and variability in composition of expressed breast milk. OBJECTIVE: A new adjustable fortification regimen has been designed to ensure that protein needs of premature infants are met at all times. The new regimen encompasses increasing the amount of fortifier and adding extra protein to breast milk guided by periodic determinations of blood urea nitrogen (BUN). The study tested the hypothesis that infants fed according to the new regimen have higher protein intakes and improved weight gain compared to infants fed according to standard fortification regimen. METHODS: In a prospective, controlled trial, preterm infants with birth weights of 600-1750 g and gestational ages between 26 and 34 weeks were fed their own mother's milk or banked donor milk or both. Infants were randomly assigned before 21 days of age to either the new adjustable fortification regimen or the standard regimen. The study period began when feeding volume reached 150 ml/kg/day and ended when infants reached a weight of 2000 g. Standard fortification (STD) consisted in the use of the recommended amount of fortifier. Adjustable fortification (ADJ) consisted in the use, in addition to standard fortification, of extra fortifier and supplemental protein guided by twice-weekly BUN determinations. The primary outcome was weight gain, with serum biochemical indicators and nutrient intakes as secondary outcomes. RESULTS: Thirty-two infants completed the study as planned (16 ADJ, 16 STD). Infants receiving the ADJ regimen had mean protein intakes of 2.9, 3.2 and 3.4 g/kg/day, respectively, in weeks 1, 2 and 3, whereas infants receiving the STD regimen had intakes of 2.9, 2.9, 2.8 g/kg/day, respectively. Infants on the ADJ regimen showed significantly greater gain in weight (17.5+/-3.0 vs 14.4+/-3.0 g/kg/day, P<0.01) and greater gain in head circumference (1.4+/-0.3 vs 1.0+/-0.3; P<0.05) than infants on the STD regimen. Weight and head circumference gain were significantly (P<0.05) correlated with protein intake. No significant correlations were found between growth parameters and intake of fat and energy. There were no significant differences between groups in BUN and other serum chemical values. In the ADJ group, BUN concentrations increased significantly (P<0.001) over time but were not significantly higher than in the STD group. CONCLUSION: Premature infants managed with the new adjustable fortification regimen had significantly higher weight and head circumference gains than infants managed with standard fortification. Higher protein intake appears to have been primarily responsible for the improved growth with the adjustable regimen. The new fortification method could be a solution to the problem of protein undernutrition among premature infants fed human milk.     

Growth hormone, somatomedin C, and nonsuppressible insulin-like activity levels compared in premature, small, average birth weight, and large infants

We have investigated the relationship between growth hormone, somatomedin C, nonsuppressible insulin-like activity, weight, gestational age, and 1-minute Apgar score in newborn infants. The 153 infants were categorized as small for gestational age (n = 19), average for gestational age (n = 59), large for gestational age (n = 60), and premature (gestational age at birth, 36 weeks or less (n = 15). Our study showed that (1) growth hormone levels were elevated in premature infants and correlated with Apgar scores and birth weights; (2) somatomedin C and nonsuppressible insulin-like activity levels were significantly lower in premature than in term infants; and (3) the birth weight of all infants studied had a significant overall effect on both somatomedin C and nonsuppressible insulin-like activity levels, suggesting that these factors may be involved in fetal growth. However, because in small for gestational age infants somatomedin C and nonsuppressible insulin-like activity were similar to levels in average for gestational age infants, it is suggested that other factors may inhibit fetal growth.     

早期新生儿骨代谢指标血清水平分析

目的 分析早期新生儿骨代谢指标血清值水平.方法 采集2018年7月至2019年12月在我院新生儿科住院的早期新生儿121例,检测血清骨代谢指标总碱性磷酸酶(ALP)、总Ⅰ型前胶原N端前肽(PINP)、β-Ⅰ型胶原交联羧基端肽区(β-CTX)、钙、磷、25-羟胆骨化醇(25-(OH)D)、甲状旁腺激素、降钙素的浓度,进行...     

宫内发育迟缓早产儿胰岛素 生长激素及皮质醇的变化和发病关系研究

摘要】目的探讨胰岛素(Ins)、生长激素(GH)、皮质醇(Cor)与早产儿宫内发育迟缓 (IUGR)的关系。方法采用放射免疫分析法检测40例IUGR早产儿和45例适于胎龄早产儿(对照组)母血、脐血和生后7日龄血清中的Ins、GH、Cor含 量，并进行分析比较。结果Ins在IUGR组脐血、生后7日龄血清中的含量明显低于对照组(P<0.05)。GH、Cor在母血中含量明显低于对照组 (P<0.05)。而脐血、生后7日龄血清中Cor含量在IUGR高于对照组，但二组比较差异无显著性(P>0.05)。结论早产儿IUGR与Ins、GH、Cor等内分 泌激素有关，它们通过调节代谢而影响胎儿宫内的生长发育，发挥着较重要的作用。     

Growth failure in the preterm infant: can we catch up?

Postnatal growth failure is extremely common in the very low birth weight and extremely low birth weight infant. Recent data from the National Institute of Child and Human Development (NICHD) Neonatal Research Network indicates that 16% of extremely low birth weight infants are small for gestational age at birth, but by 36 weeks corrected age, 89% have growth failure. Follow-up at 18 to 22 months corrected age shows that 40% still have weights, lengths, and head circumferences less than the 10th percentile. Growth failure is associated with an increased risk of poor neurodevelopmental outcome. Inadequate postnatal nutrition is an important factor contributing to growth failure, as most extremely low birth weight infants experience major protein and energy deficits during the neonatal intensive care unit hospitalization, in spite of the fact that nutrition sufficient to support intrauterine growth rates can generally be provided safely. Aggressive nutritional support--parenteral and enteral--is well tolerated in the extremely low birth weight infant and is effective in improving growth. Continued provision of appropriate nutrition (premature formula or fortified human milk) is important throughout the neonatal intensive care unit stay. After discharge, nutrient-enriched postdischarge formula should be continued for approximately 9 months post-term. Exclusively breast-fed infants require additional supplementation/fortification postdischarge as well. Additional trials are needed to address a number of important questions concerning the role of nutrition and growth on ultimate development.     

The relationship among intrauterine growth, insulinlike growth factor I (IGF-I), IGF-binding protein-3, and bone mineral status in newborn infants

Insulinlike growth factors (IGFs) exert profound effects on somatic growth and cellular proliferation of many tissues and play an essential role in bone metabolism. The aim of this study was to investigate how fetal growth and bone mineralization correlate with IGF-I and IGF-binding protein-3 (IGFBP-3) levels of newborn infants and their mothers. In addition, we aimed to determine the predictive value of anthropometric measurements on variability in bone mineral status. Umbilical cord venous blood samples were obtained at delivery from 100 term newborn infants. Forty of the newborn infants had birthweights appropriate for gestational age (AGA), 30 were small for gestational age (SGA), and 30 were large for gestational age (LGA). Data were acquired using whole-body dual-energy X-ray absorptiometry scanner with a pediatric platform. Umbilical cord serum IGF-I concentrations were higher in LGA newborns ( P < 0.01), but lower in SGA newborns ( P < 0.01) than in AGA newborns. Umbilical cord serum IGFBP-3 concentrations in LGA newborns were significantly greater than in SGA and AGA newborns ( P < 0.01 and P < 0.01, respectively). Whole-body bone mineral density (WB BMD) was higher in LGA babies (0.442 +/- 0.025 g/cm2 [SD]; P < 0.01) but lower in SGA (0.381 +/- 0.027 g/cm 2; P < 0.0001) than in AGA babies (0.426 +/- 0.022 g/cm2). WB BMD and content (WB BMC) were correlated significantly with birthweight, birth height, head circumference, body mass index (BMI) of the infants; ponderal index and triceps skinfold thickness (reflecting fat stores) of the infants; cord serum IGF-I concentration, serum IGF-I concentration of the mothers; and fat mass, proportionate fat mass, weight, and BMI of the mothers. In contrast, WB BMC was also correlated positively with cord serum IGFBP-3 concentration and gestational age, and WB BMD was positively correlated with serum IGFBP-3 levels of the mothers. Umbilical cord serum IGF-I concentration of the infants was correlated significantly with the concentration of the mothers ( R = 0.232; P = 0.020). Umbilical cord serum IGF-I and IGFBP-3 concentrations were correlated significantly with the fat mass, gestational age, birthweight, birth height, head circumference, and BMI of the infants. Umbilical cord IGF-I concentration was also correlated with ponderal index and triceps skinfold thickness of the infants, maternal weight, BMI, and proportionate fat mass of the infants. Stepwise multiple regression analyses showed no significant relation between bone indices (WB BMD, WB BMC) and the infant's or mother's variations including serum IGF-I and IGFBP-3 concentrations. Birthweight and gestational age are related to bone indices. However, the present study does not provide support for the hypothesis that serum IGF-I and IGFBP-3 levels of infants and their mothers may play a major role in the regulation of bone metabolism in the developing skeleton.     

早产儿甲状腺功能检测及分析

目的 研究早产儿甲状腺功能。方法 将青岛大学医学院附属医院2004年10月至2005年10月收治的早产儿60例按胎龄分成两组：小胎龄早产儿组(A组，胎龄<34周，n1=30)，大胎龄早产儿组(B组，胎龄≥34周，n2=30)。对照组为我院出生的正常足月儿30例，应用放免法对3组新生儿生后第1，7天血清游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平进行测定。结果 A、B组及对照组血清FT3、FT4生后1~7d呈下降趋势；对照组生后第1，7天血清FT3、FT4明显高于A、B组，B组明显高于A组；血清TSH在A、B及对照组生后呈下降过程；生后第1天对照组TSH>A组>B组；生后第7天，血清TSH A组高于B组和对照组，而B组与对照组差异无显著性。结论 早产儿生后甲状腺功能有暂时性低下，胎龄越小，功能越低，生后应激反应持续时间越长。 Abstract ObjectiveTo investigate the thyroid function in the premature infants.MethodsFrom Oct.2004 to Oct.2005 serum free triodothyrorine (FT3),free thyroxine (FT4) and thyrotropin (TSH) in 60 premature infants on the 1st,7th days after birth were detected by radioimmunoassay (RIA) and were compared with those in 30 normal neonate controls.The 60 premature infants were divided into two groups according to the gestational age:the very premature infants (the group A,less than 34 weeks of gestational age,n1=30) and the older gestational age infants (the group B,34~41 weeks of gestational age,n2=30).ResultsThe serum concentrations of FT3,FT4,TSH showed a declining tendency in all neonates from the 1st day to the 7th day after birth.The serum concentrations of FT3，FT4 on the 1st and 7th day after birth were significantly higher in the controls than those in group A and group B,and those in group B were also significantly higher than those in group A.The serum TSH on the 1st and 7th day after birth were significantly higher in the controls than those in both group A and B,and those in group A were also significantly higher than those in group B.On the 7th day after birth,the serum TSH in group A were higher than those in group B and controls,whereas the serum TSH were not significantly different between group B and controls.ConclusionThe thyroid function in the premature infants is transiently low.The shorter the gestational age,the lower the thyroid function and the longer the stress reaction. Key wordsPremature infants;Thyroid function     

The association of birthweight with maternal and cord serum and amniotic fluid growth hormone and insulin levels, and with neonatal and maternal factors in pregnant women who delivered at term

AIM: To investigate the influence of maternal and cord serum and amniotic fluid growth hormone (GH) and insulin and other neonatal and maternal factors on birthweight. METHODS: A total of 160 pregnant women at 38-42 weeks' gestation were studied. All infants were categorized as small for gestational age (SGA) (n = 50), large for gestational age (LGA) (n = 50) or average for gestational age (AGA) (n = 60). GH and insulin levels were measured in maternal and cord serum and amniotic fluid at birth. RESULTS: GH levels in maternal and cord serum and amniotic fluid showed no differences among the three weight groups (P > 0.05). The cord insulin level was significantly lower in SGA (P < 0.01). The insulin level in venous cord blood correlated with birth and placental weights and neonatal height, whereas maternal serum and amniotic fluid insulin levels, and maternal and cord serum and amniotic fluid GH levels did not show any correlation with birthweight. The cord GH level at birth was correlated with GH levels after 4 postnatal weeks in the SGA group (P < 0.01). In addition, birthweight showed a correlation with prepartum maternal weight, maternal weight gain, maternal height, neonatal length and placental weight in all three weight groups. CONCLUSIONS: Cord GH, maternal serum and amniotic fluid GH and insulin levels did not correlate with birthweight in all three weight groups. The lack of correlation for GH levels in maternal and cord serum and amniotic fluid suggests that these compartments may be non-communicating separate units.     

早产儿支气管肺发育不良危险因素分析及防治措施

目的 分析早产儿支气管肺发育不良(BPD)的发生率和危险因素，探讨防治BPD的措施。方法 回顾性分析中山大学第一附属医院新生儿科1999年6月至2004年6月期间胎龄≤32周且出生体重≤2000g，存活时间>28d的早产儿72例，比较机械通气治疗中15例BPD(BPD组)和31例非BPD(对照组)患儿性别、胎龄、出生体重、生前使用糖皮质激素、生后使用肺表面活性物质、肺透明膜病、机械通气时间、呼吸支持条件、胃食管反流、动脉导管未闭、生后早期液体摄取量、反复肺部感染情况。结果早产儿BPD的总发生率为20.83%(15/72)，其中<1500g早产儿BPD的发生率为38.71%(12/31)；BPD组FiO2、PIP、PEEP和MAP与对照组差异无显著性意义(P>0.05)；多因素Logistic回归显示，胎龄<30周、体重<1250g、机械通气≥10d和反复肺部感染是发生BPD的独立危险因素(P<0.05)，而性别、生前使用糖皮质激素、生后使用肺表面活性物质、肺透明膜病、胃食管反流、动脉导管未闭、生后早期液体摄取量没有统计学意义(P>0.05)。结论 避免低体重早产、长时间机械通气和有效控制肺部感染是防治BPD的关键。 Abstract Objective To study the incidence,risk factors,prophylaxis and treatment for bronchopulmonary dysplasia (BPD) in premature.Methods From June 1999 to June 2004 seventy two prematures with gestational age less than 32 weeks,birth weight less than 2000 grams and surviving more than 28 days were enrolled in the study.Fifteen prematures with BPD were compared to thirty one prematures without BPD in terms of sex,gestational age,birth weight，usage of prenatal steroids,usage of postnatal surfactant,hyaline membrane disease,duration of mechanical ventilation,supportive conditions for ventilation,gastroesophageal reflux,patent ductus arteriosus,fluid intake in the first few days and recurrent pneumonia.Results The overall incidence of BPD in preterm newborns was 20.83%,and 38.71% in those infants weighting <1500g at birth；Fio2,PIP,PEEP and MAP were all not statistically significant between BPD group and control (P>0.05)；Multivariate logistic analysis revealed that gestational age less than 30 weeks,birth weight less than 1250 grams,prolonged mechanical ventilation (≥10days) and recurrent pneumonia were independent risk factors for BPD (P<0.05).Other factors including sex,usage of prenatal steroids,usage of postnatal surfactant,hyaline membrane disease,gastroesophageal reflux and excessive fluid intake in the first few days of life were not statistically significant (P>0.05).Conclusion Preventing small gestational age and low birth weight prematurity,shortening the duration of mechanical ventilation and controlling pneumonia were effective in preventing BPD. Key words Premature;Bronchopulmonary dysplasia;Risk factors