早产儿支气管肺发育不良与早产儿脑病相关性研究

目的 探讨早产儿支气管肺发育不良(bronchopulmonary dysplasia,BPD)与早产儿脑病(encephalopathy of prenmturity,EOP)的相关性,为临床评估患者预后及采取合适的干预措施提供理论依据。 方法 选取郑州大学附属儿童医院早产儿重症监护室2014年2月—2018年2月收治的BPD早产儿124例,非BPD患儿248例为对照组,纠正胎龄37~42周行头颅磁共振成像(magnetic resonance imaging,MRI)检查,分析2组早产儿发生EOP的情况。 结果 BPD组晚发败血症发生40例(32.2%),发生率明显高于对照组42例(16.9%),P<0.05;BPD组早产儿发生EOP 41例(33.1%),明显高于对照组40例(16.1%),差异有统计学意义(P<0.001);84例轻度BPD患儿发生EOP 17例(20.2%),40例中重度BPD患儿发生EOP 24例(60.0%),中重度BPD患儿EOP发生率高于轻度BPD组患儿,差异有统计学意义(P<0.001);BPD组EOP中脑白质损伤发生比例高于对照组,差异有统计学意义(P<0.05)。 结论 早产儿BPD与EOP的发生具有一定相关性,感染是BPD患儿发生EOP的危险因素,应加强感染监测及神经系统随访评估。 

A correlation study of bronchopulmonary dysplasia and encephalopathy of prematurity in premature infants

Objective To study the correlation of bronchopulmonary dysplasia(BPD) and encephalopathy of prematurity(EOP) in premature infants,and to provide the theoretical basis for clinical evaluation of prognosis and appropriate intervention measures. Methods From February 2014 to February 2018, 124 preterm infants with BPD in intensive care unit of children affiliated to Zhengzhou University were chosen,248 patients without BPD were assigned into the control group. The head magnetic resonance imaging examination was performed at the corrected gestational age of 37-42 weeks. The incidence and imaging characteristics of EOP in the two groups were analyzed. Results Forty cases(32.2%) of late-onset sepsis occurred in BPD group, which was significantly higher than that of 42 cases in control group(16.9%),P<0.05. EOP occurred in 41 premature infants(33.1%) in BPD group, which was significantly higher than that in control group(16.1%), P<0.001. There were 17 cases(20.2%) of EOP in 84 cases of mild BPD and 24 cases(60%) of EOP in 40 cases of moderate and severe BPD. The incidence rate of EOP in moderate and severe BPD group was significantly higher than that in mild BPD group(P<0.001). The incidence rate of white matter injury in EOP in BPD group was significantly higher than that in control group(P<0.05). Conclusion BPD and EOP may be correlated in preterm infants. Infection is a risk factor of EOP for premature infants with BPD,and surveillance of infection and follow-up evaluation of nervous system should be strengthened.