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[具有特殊呼吸模式的高危SID儿童的既往史因素]

[Anamnestic factors in at-risk SID children with peculiar breathing pattern].

作者信息

Glaser S, Scholle S, Scheidt B, Zwacka G

机构信息

Universitäts-Kinderklinik Jena.

出版信息

Klin Padiatr. 1992 Jan-Feb;204(1):6-9. doi: 10.1055/s-2007-1025314.

Abstract

436 out of about 9000 infants who were born between April 1987 and November 1990 in Jena were selected by means of a risk score for a polygraphy monitoring. This score contains anamnestic factors of the mother and the infant which are characteristic of an enhanced risk for the sudden infant death syndrome (SIDS). We performed a day-time polysomnography (ECG, heart rate, respiration, EEG, EOG, EMG) with a sleep duration of at least one hour. 23 of the infants investigated demonstrated abnormal breathing patterns (increased mean apnea duration, apneas longer than 15 s, apneas with bradycardia) and were treated with aminophylline to prevent a possible SIDS event. Now we investigated the statistical relation between 26 anamnestic factors of our risk score and the need for treatment. In univariate statistical comparisons treated infants differed from untreated infants concerning the occurrence of intraventricular haemorrhages (IVH), the gestational age (GA) (preterm of fullterm) and the occurrence of hyperbilirubinemia (HB) in their anamnesis. In a multivariate analysis with all 26 factors the birth weight was the third important factor beside IVH and GA, but only factor IVH was statistically significant. A cluster analysis of the variables with respect to the separation of the two groups of infants indicates that the variables IVH, GA and HB strongly correlate. In the light of these results we can underline that abnormal breathing patterns can be expected especially in infants with IVH, short GA and low birth weight.

摘要

1987年4月至1990年11月在耶拿出生的约9000名婴儿中,有436名通过多导睡眠图监测风险评分被选中。该评分包含母亲和婴儿的既往史因素,这些因素是婴儿猝死综合征(SIDS)风险增加的特征。我们进行了一次白天的多导睡眠图检查(心电图、心率、呼吸、脑电图、眼电图、肌电图),睡眠持续时间至少为一小时。接受调查的23名婴儿表现出异常呼吸模式(平均呼吸暂停持续时间增加、呼吸暂停超过15秒、伴有心动过缓的呼吸暂停),并接受了氨茶碱治疗以预防可能的SIDS事件。现在我们研究了风险评分中的26个既往史因素与治疗需求之间的统计关系。在单变量统计比较中,接受治疗的婴儿与未接受治疗的婴儿在其既往史中的脑室内出血(IVH)发生率、胎龄(GA)(早产或足月)以及高胆红素血症(HB)发生率方面存在差异。在对所有26个因素进行的多变量分析中,出生体重是IVH和GA之外的第三个重要因素,但只有IVH因素具有统计学意义。对这些变量进行聚类分析以区分两组婴儿,结果表明变量IVH、GA和HB密切相关。根据这些结果,我们可以强调,尤其是在患有IVH、胎龄短和出生体重低的婴儿中,可能会出现异常呼吸模式。

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