早产儿出生前硫酸镁暴露量与脑损伤关系的研究

目的探讨早产儿出生前硫酸镁暴露量与脑损伤关系。方法对119例28～36周的早产儿按母亲产前应用硫酸镁的累积剂量分为3组：Ⅰ组为≤15g组48例,Ⅱ组为〉15g但≤45g组41例,Ⅲ组为〉45g组30例,于生后3～7天内常规进行头颅CT检查,对不同组脑损伤发生率、胎龄、出生体重与脑损伤发生率的关系进行分析。结果44例早产儿存在脑损伤,总的脑损伤发生率36.9%（44/119）。其中Ⅰ组发生率为25%（12/48）,Ⅱ组发生率为24.4%（10/41）,Ⅲ组发生率为73.3%（22/30）,三组间发生率对比差异有统计学意义（χ2=2.75,P〈0.01）,发生率两两间比较Ⅰ组及Ⅱ组分别低于Ⅲ组,且胎龄越小,出生体重越小,脑损伤发生率越高。结论早产儿出生前硫酸镁暴露量〉45g可增加脑损伤的发生率,硫酸镁在治疗早产中的安全剂量范围需进一步评估。

Investigation of Relationship Between Prenatal Exposure to Magnesium Sulfate (MgSO4) and Cerebral Injury in Preterm Infant

Objective：To investigate the relationship between prenatal exposure to magnesium sulfate（MgSO4） and cerebral injury in preterm infant.Method：119 preterm infants from 28 to 36 weeks gestation were divided into three groups,according to the accumulated dose of treating with MgSO4 before labour in their mothers,of whom,48 cases of group Ⅰ were exposed to ≤15g,41 of group Ⅱ were 〉15g and ≤45g,30 of group Ⅲ were 〉45g,all were taken Head CT 3 and 7 days after borning,to compare the incidence rate of the cerebral injuries among different therapy groups,analyze correlationship between cerebral injury and gestational age,birth weight.Result：44 cases had cerebral injury,the incidence rate of the cerebral injuries was 36.9%,among them there were 12 in group Ⅰ,10 in group Ⅱ,22 in group Ⅲ,the differences among the three groups were significant（χ2=22.75,P〈0.01）,Comparison in subgroups：the rate in group Ⅰ and group Ⅱ were significantly lower than that in group Ⅲ,the incidence of cerebral injury increased with the smaller gestational age and lower birth weight.Conclusion：In preterm infants exposed to 〉45g MgSO4 before borning,the incidence of cerebral injury increased,It should be further studied on the MgSO4 safe dosage scope.