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目的探讨早产儿动脉导管未闭(PDA)发生的有关危险因素。方法对2008年1～12月在我院新生儿科住院751例早产儿进行回顾性分析,其中133例行超声心动图检查,48例诊断PDA为病例组,85例非PDA为对照组,对两组临床资料进行对照研究,应用Logistic回归模型分析。结果单因素分析显示,胎龄、出生体重、母亲产前用激素、胎儿宫内窘迫、吸氧、出生窒息、呼吸衰竭、肺透明膜病、败血症、液体摄入、超声心动图检查时机与早产儿PDA的发生有关联,其OR值分别为2.636、2.755、0.311、12、0.431、3.692、3.038、7.085、2.282、2.581、1.026、0.474;Logistic回归分析表明小胎龄、低出生体重、出生窒息、败血症是主要危险因素,其OR值分别是2.517、2.957、13.770、3.493,而母亲产前用激素、吸氧是主要保护因素,其OR值是0.208和0.127。结论早产儿发生PDA与围生期多种因素有关,有针对性开展围生期保健是降低早产儿PDA的有效措施。
Objective To investigate the risk factors of patent ductus arteriosus (PDA) in preterm infants. Methods A retrospective analysis was performed on 751 preterm infants admitted to neonatology department in our hospital from January to December in 2008. Among them, 133 cases were examined by echocardiography, 48 cases were diagnosed PDA as case group, 85 cases were non-PDA as control group, Group clinical data were compared with Logistic regression model analysis. Results Univariate analysis showed that gestational age, birth weight, maternal prenatal steroid, fetal distress, oxygen inhalation, birth asphyxia, respiratory failure, hyaline membrane disease, sepsis, fluid intake, echocardiography timing and preterm birth PDA were associated with the occurrence of their OR values were 2.636,2.755,0.311,12,0.431,3.692,3.038,7.085,2.282,2.581,1.026,0.474; Logistic regression analysis showed that small gestational age, low birth weight, birth asphyxia , Sepsis is the main risk factor, the OR values are 2.517,2.957,13.770,3.493, respectively, while the mother prenatal hormone, oxygen is the main protective factor, the OR value is 0.208 and 0.127. Conclusions The occurrence of PDA in preterm infants is related to many factors in perinatal period. Targeted perinatal care is an effective measure to reduce PDA in preterm infants.