早产儿晚发性循环衰竭的神经发育临床特征和长期预后。
Clinical characterization and long-term prognosis of neurological development in preterm infants with late-onset circulatory collapse.
机构信息
Department of Neonatology, Osaka City General Hospital, Osaka, Japan.
出版信息
J Perinatol. 2010 Nov;30(11):751-6. doi: 10.1038/jp.2010.41. Epub 2010 Apr 1.
OBJECTIVE
To characterize the risk factors for late-onset circulatory collapse (LCC) in preterm infants responsive to corticosteroid therapy and evaluate the long-term neurological prognosis.
STUDY DESIGN
A retrospective case-control study for preterm infants (≤32 weeks' gestation) admitted to our neonatal intensive care unit from 1994 through 2002.
RESULT
Sixty-five infants (11%) were diagnosed with LCC. Infants with a shorter gestation and lower birth weight had a higher incidence of LCC. LCC infants had a significantly lower 1-min Apgar score, significantly higher incidence of severe intraventricular hemorrhage, chronic lung disease, and postnatal periventricular leukomalacia, and significantly longer duration of ventilation use, oxygen use, and hospital stay. Somatic growth at 36 weeks' postmenstrual age was poorer in infants with LCC than without LCC (controls). LCC infants were significantly more likely than controls to have cerebral palsy at 3 years.
CONCLUSION
LCC is associated with poor neurodevelopmental outcomes. Prevention of LCC can lead to improved neurological prognoses.
目的
分析对皮质激素治疗有反应的早产儿发生迟发性循环衰竭（LCC）的危险因素，并评估其长期神经预后。
研究设计
这是一项回顾性病例对照研究，纳入了 1994 年至 2002 年在我院新生儿重症监护病房（NICU）住院的早产儿（胎龄≤32 周）。
结果
共 65 例（11%）早产儿被诊断为 LCC。胎龄和出生体重越小的患儿，LCC 的发生率越高。LCC 患儿的 1 分钟 Apgar 评分显著较低，严重脑室出血、慢性肺疾病和围生期脑白质软化症的发生率显著较高，通气、吸氧和住院时间显著延长。与无 LCC 的患儿（对照组）相比，发生 LCC 的患儿在 36 周龄时的体格生长更差。LCC 患儿在 3 岁时脑瘫的发生风险显著高于对照组。
结论
LCC 与不良的神经发育结局相关。预防 LCC 可改善神经预后。
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