呼吸严重程度评分联合氧合指数预测极/超低出生体重儿支气管肺发育不良的价值

目的研究呼吸严重程度评分(RSS)联合氧合指数预测极/超低出生体重儿支气管肺发育不良(BPD)的价值。方法回顾性分析2016年11月至2020年11月在安徽医科大学第一附属医院妇产科出生转运至新生儿科需气管插管呼吸支持且机械通气时间>12 h的极/超低出生体重儿的临床资料,分别计算入院时初始上机RSS评分和氧合指数。将患儿分为BPD组和非BPD组,使用logistic回归分析发生BPD的影响因素,受试者工作特征(ROC)曲线预测两种指标的预测价值。结果符合纳入条件新生儿72例,BPD组40例,非BPD组32例。结果显示,两组上机时RSS评分及氧合指数比较,差异均有统计学意义(P<0.05)。logistic回归分析结果显示,上机时RSS评分、氧合指数是极/超低出生体重儿BPD发生的高危因素(P<0.05)。ROC曲线显示,上机时RSS评分及氧合指数联合预测效能最高(AUC为0.957),其次为上机时RSS评分(AUC为0.931),再次之为氧合指数(AUC为0.891)。结论上机时RSS评分联合氧合指数对极/超低出生体重儿BPD具有一定的预测价值。

Value of respiratory severity score and oxygenation index in predicting bronchopulmonary dysplasia in very/extremely low birth weight infants

Objective To study the value of respiratory severity score(RSS)combined with oxygenation index in predicting bronchopulmonary dysplasia(BPD)in very/extremely low birth weight infants.Methods The clinical data of very/extremely low birth weight infants born in the Obstetrics and Gynecology Department of the First Affiliated Hospital of Anhui Medical University from November 2016 to November 2020 who needed endotracheal intubation respiratory support and mechanical ventilation time>12 hours were analyzed retrospectively.The initial RSS score and oxygenation index at admission were calculated respectively.The children were divided into BPD group and non BPD group.The influence factors of BPD were analyzed by logistic regression,and the predictive value of two indexes was predicted by receiver operating characteristics(ROC)curve.Results 72 newborns met the inclusion conditions,40 in BPD group and 32 in non BPD group.The results showed that there were significant differences in RSS score and oxygenation index between the two groups(P<0.05).The results of logistic regression analysis showed that the RSS score and oxygenation index were high-risk factors for the occurrence of BPD in very/extremely low birth weight infants(P<0.05).The ROC curve showed that the combined predictive performance of RSS score and oxygenation index was the highest(AUC was 0.957),followed by RSS score(AUC was 0.931),and then oxygenation index(AUC was 0.891).Conclusion RSS score combined with oxygenation index has a certain predictive value for BPD in very/extremely low birth weight infants.