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目的分析导致早产儿脑损伤的相关危险因素。方法以2006年1月至2009年6月入住安徽省立儿童医院新生儿科的443例早产儿为研究对象,分为脑室周围白质软化(PVL)组(125例)与无PVL组(318例),按PVL级别分为非囊性PVL组(116例)和囊性PVL组(9例),采用头颅超声诊断技术早期诊断早产儿PVL,用多因素分析影响PVL及其不同级别的高危因素。结果单因素分析显示:胎龄、出生体重、分娩方式、低体温、生后感染、呼吸暂停、血糖、心肌酶谱、C-反应蛋白(CRP)和血清白蛋白在PVL组和无PVL组之间差异有统计学意义(P<0.05或P<0.01)。多因素Logistic回归分析显示:出生体重低、母亲低剖宫产率、生后感染及血清白蛋白和心肌酶谱水平高是早产儿发生PVL的危险因素,另外,生后感染是发生囊性PVL的危险因素。结论出生体重低、母亲低剖宫产率、生后感染及血清白蛋白和心肌酶谱高是早产儿发生PVL的危险因素,另外,生后感染的早产儿发生囊性PVL的风险较高。
Objective To analyze the related risk factors of brain injury in premature infants. Methods From January 2006 to June 2009, 443 premature infants admitted to Department of Neonatology, Provincial Children’s Hospital of Anhui Province were divided into two groups: periventricular leukomalacia (PVL) group (n = 125) and no PVL group (n = 318) PVL group was divided into non-cystic PVL group (116 cases) and cystic PVL group (9 cases). Ultrasound diagnosis of PVL was carried out in early stage by using the method of cranial ultrasound. Multivariate analysis was used to evaluate the risk factors of PVL and its different grades. Results Univariate analysis showed that gestational age, birth weight, modes of delivery, hypothermia, postnatal infection, apnea, blood glucose, myocardial enzymes, C-reactive protein and serum albumin in PVL and PVL The difference was statistically significant (P <0.05 or P <0.01). Multivariate logistic regression analysis showed that low birth weight, low mothers cesarean section rate, postnatal infection, and high serum albumin and myocardial enzymes were risk factors for PVL in preterm infants. In addition, postnatal infection was cystic PVL Risk factors. Conclusions Low birth weight, low cesarean section rate, postnatal infection, high serum albumin and myocardial enzyme level are risk factors for PVL in preterm infants. In addition, the risk of cystic PVL is high in preterm infants with postnatal infection.