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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。
Objective To explore the factors that affect and aggravate anemia in premature infants. Methods Preterm infants with anemia during hospitalization from January 2012 to June 2013 in our hospital were divided into groups according to gestational age, birth weight, basal hemoglobin (Hb) at birth and whether there was mechanical ventilation. The occurrence of anemia in each group and the lowest Hb during hospitalization. Results Anemia was (12.9 ± 5.0) days, (12.5 ± 4.1) days and the lowest Hb was (94.3 ± 14.1) g / L in preterm infants with gestational age <32 weeks and birth weight <1500 g 90.0 ± 10.3) g / L. With the increase of gestational age and birth weight, anemia appeared delayed and relieved (all P <0.05). Preterm infants with a basal Hb value of ≤145 g / L at birth had a mean anemia of (7.1 ± 1.4) days, an average Hb of (100.0 ± 9.2) g / L, and a basal Hb of> 145 g / L at birth Compared with premature infants, anemia was earlier (P <0.05). The duration of anemia required mechanical ventilation was (10.5 ± 3.4) days and the mean Hb was (88.7 ± 9.5) g / L, with anemia occurring earlier and heavier (P <0.05) than the non-mechanical ventilation group. Multivariate linear regression analysis showed that gestational age, birth weight and basal Hb values were the influencing factors of premature infant anemia, gestational age and basal Hb value were the factors affecting the lowest Hb value. Conclusion The smaller the gestational age, the lower the birth weight, the earlier the onset of anemia and the heavier the anemia. The lower the basal Hb value, the earlier the anemia occurs. Need mechanical ventilation due to illness, by a variety of factors may aggravate premature anemia.