作者：郭九叶1，宗心南2，常韶燕2，高月乔1，张丽1，邱如新1

单位：

1.100021北京市朝阳区妇幼保健院新生儿科　2.100020北京市，首都儿科研究所儿童发育营养组学北京市重点实验室

Units：

1.Department of Neonatology, Beijing Chaoyang District Maternal and Child Healthcare Hospital, Beijing 100021, China2.Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing 100020,China

关键词：

颅内出血；早产儿；危险因素；出生体质量

Keywords：

Intracranial hemorrhages; Preterm infants; Risk factors; Birth weight

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.183

Funds：

摘要：

目的　探讨早产儿发生脑室周围-脑室内出血（PIVH）的影响因素。方法　选取2017年3月至2021年12月北京市朝阳区妇幼保健院新生儿科收治的509例早产儿为研究对象，根据颅脑超声检查结果将发生PIVH的早产儿作为出血组，未发生PIVH的早产儿作为未出血组。采用单因素分析及多因素Logistic回归分析探讨早产儿发生PIVH的影响因素。结果　509例早产儿中共180例（35.4%）发生PIVH，其中Ⅰ级30例、Ⅱ级123例、Ⅲ级25例、Ⅳ级2例。出血组母亲高龄者占比及患儿胎龄≤32周、出生体质量≤1 500 g、出生后窒息、呼吸困难、使用有创呼吸机、使用肺表面活性物质、首次感染指标异常者占比高于未出血组（P ＜0.05）。多因素Logistic回归分析结果显示，患儿胎龄≤32周〔OR =2.831，95%CI （1.314，6.102）〕、出生体质量≤1 500 g〔OR =6.210，95%CI （2.439，15.807）〕、首次感染指标异常〔OR =9.532，95%CI （5.710，15.910）〕是早产儿发生PIVH的危险因素，使用表面活性物质〔OR =0.311，95%CI （0.141，0.685）〕是早产儿发生PIVH的保护因素（P ＜0.05）。结论　患儿胎龄≤32周、出生体质量≤1 500 g、首次感染指标异常是早产儿发生PIVH的危险因素，使用肺表面活性物质是早产儿发生PIVH的保护因素。

Abstract：

Objective　To investigate the risk factors of periventricular-intraventricular hemorrhage（PIVH）inpremature infants. Methods　A total of 509 premature infants admitted to Department of Neonatology of Beijing Chaoyang DistrictMaternal and Child Healthcare Hospital from March 2017 to December 2021 were selected as the research objects. According tothe results of brain ultrasound, the premature infants with PIVH were regarded as the hemorrhage group, and the premature infantswithout PIVH were regarded as the non-hemorrhage group. Univariate analysis and multivariate Logistic regression analysis wereused to explore the influencing factors of PIVH in preterm infants. Results　Among the 509 premature infants, 180 cases (35.4%)had PIVH, including 30 cases of grade Ⅰ, 123 cases of grade Ⅱ, 25 cases of grade Ⅲ, and 2 cases of grade Ⅳ. The proportion ofelderly mothers, the proportion of the gestational age ≤ 32 weeks, the birth weight ≤ 1 500 g, asphyxiated after birth, having difficultybreathing, using invasive ventilator, using pulmonary surfactant, and abnormal indicators of first infection in preterm infants ofthe bleeding group were higher than those of the non-bleeding group (P < 0.05) . Multivariate Logistic regression analysis showedthat gestational age ≤ 32 weeks [OR =2.831, 95%CI (1.314, 6.102) ] , birth weight ≤ 1 500 g [OR =6.210, 95%CI (2.439, 15.807) ] ,abnormal indicator of first infection [OR =9.532, 95%CI (5.710, 15.910) ] were the risk factors for PIVH in premature infants, and theuse of surfactants [OR =0.311, 95%CI (0.141, 0.685) ] was the protective factor for PIVH in premature infants (P < 0.05) . Conclusion　Gestational age ≤ 32 weeks, birth weight ≤ 1 500 g, and abnormal indicators of first infection were risk factors for PIVH in preterminfants, and the use of pulmonary surfactant was a protective factor for PIVH in preterm infants.

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