中国冶金工业医学杂志

早产儿支气管肺发育不良的相关因素探讨

作者：刘莹1 孙建梅2

单位：1大连市妇幼保健院新生儿科辽宁大连 116033 2上海市奉贤区中心医院儿科

分类号：中图分类号：R 722文献标志码：A文章编号：1005-5495(

出版年,卷(期):页码：2013,30(5):508-509

摘要：

摘要：目的支气管肺发育不良（BPD）发病因素复杂,本文以多因素分析法分析其独立危险因素,并分析因素间的交互作用,为该病防治提供依据。方法采用病例对照研究对BPD 36种危险因素进行调查,对单因素分析中有显著性意义的因素进行非条件logistic回归分析,并以加法模型理论分析因素间的交互作用。结果单因素分析显示男婴、胎龄≤32周、出生体重≤1500 g、胎膜早破、产道感染、孕母产前羊膜炎、PDA、反复肺部感染、机械通气＞10 d、碳青霉烯类抗生素＞4周等10个危险因素差异有统计学意义(P＜005);非条件logistic回归分析显示胎龄≤32周(OR=78394)、胎膜早破(OR=29313)、孕母产前羊膜炎(OR=77790)、反复感染性肺炎(OR=78120)、碳青霉烯类抗生素＞4周(OR=74699)为BPD的独立危险因素;交互分析显示,胎龄≤32周与机械通气＞10 d、胎龄≤32周与出生体重≤1500 g、胎龄≤32周与反复肺部感染、出生体重≤1500 g与反复肺部感染(X19)等之间存在正交互作用(交互指数大于1)。结论该病的发生与多种独立危险因素有关,多个危险因素并存亦加大了该病发生的可能性，临床上应加强对相关危险因素的监测和处理。

Abstract:ObjectiveAnalyze the risk factors for bronchopulmonary dysplasia(BPD）and the interactions between them,to provide evidence for prevention.MethodsAcase\|control study was conducted to investigate 36 potential risk factors for BPD.The significant risk factors in monovariable analysis were selected for the non\|conditional logistic regression analysis.The interactions of the risk factors were evaluated using an additive model.ResultsIt was showed that male infant,gestational age less than 32 weeks，birth weigh less than 1500 g,premature rupture of fetal membranes,obstetric canal infection,chorioamnionitis,PDA,repeated pneumonia,mechanical ventilation cure more than 10 days,administering advanced broad\|spectrum antibiotics more than 4 weeks were significant(P＜005)with monovariable analysis.Non\|conditional logistic regression analysis indicated gestational age less than 32 weeks(OR=78394),premature rupture of fetal membranes(OR=29313),chorioamnionitis(OR=77790),repeated pneumonia（OR=78120），administering advanced broad\|spectrum antibiotics more than 4 weeks(OR=74699)were independent risk factors for BPD.The interaction analyses showed that there were positive interactions between gestational age less than 32 weeks and mechanical ventilation cure more than 10 days,birth weight less than 1500 g,repeated pneumonia, as well as birth weight less than 1500 g and repeated pneumonia(synergy index＞1). ConclusionRisk factors for BPD are varied.The coexistence of the multiple risk factors may increase the incidence of BPD.So it is important to monitor and control all potential risk factors in clinical.

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参考文献：

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