Ruan Qiqi, Wang Jianhui, Shi Yuan
Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, China.
National Clinical Research Center for Child Health and Disorders, Chongqing, China.
Front Pediatr. 2021 Aug 23;9:712516. doi: 10.3389/fped.2021.712516. eCollection 2021.
The goal of the current study was to assess the associations of typical chest imaging findings of bronchopulmonary dysplasia (BPD) in preterm infants with clinical characteristics and outcomes until 2 years of age. This retrospective cohort study enrolled 256 preterm infants with BPD who were admitted between 2014 and 2018. A propensity score analysis was used to adjust for confounding factors. The primary outcomes were the severity of BPD, home oxygen therapy (HOT) at discharge and mortality between 28 days after birth and 2 years of age. A multivariate logistic regression analysis was performed to identify related variables of mortality. Seventy-eight patients with typical chest imaging findings were enrolled, of which 50 (64.1%) were first found by CXR, while 28 (35.9%) were first found by CT. In addition, 85.9% (67/78) were discovered before 36 weeks postmenstrual age (PMA) (gestational age [GA] < 32 weeks) or before 56 days after birth (GA > 32 weeks). After propensity score matching, the matched groups consisted of 58 pairs of patients. Those with typical imaging findings had a remarkably higher mortality rate (29.3 vs. 12.1%, = 0.022, OR 3.021), higher proportion of severe BPD (32.8 vs. 12.1%, = 0.003, OR 4.669) and higher rate of HOT at discharge (74.1 vs. 46.6%, = 0.002, OR 3.291) than those without typical imaging findings. The multivariate logistic regression analysis showed that typical imaging findings ≤ 7 days and typical typical imaging findings >7 days were independent risk factors for mortality in preterm infants with BPD (OR 7.794, = 0.004; OR 4.533, = 0.001). More attention should be given to chest imaging findings of BPD, especially in the early stage (within 7 days). Early recognition of the development of BPD helps early individualized treatment of BPD. www.ClinicalTrials.gov, identifier: NCT04163822.
本研究的目的是评估早产儿支气管肺发育不良（BPD）典型胸部影像学表现与临床特征及2岁前预后的相关性。这项回顾性队列研究纳入了2014年至2018年间收治的256例患有BPD的早产儿。采用倾向评分分析来调整混杂因素。主要结局指标为BPD的严重程度、出院时的家庭氧疗（HOT）以及出生后28天至2岁之间的死亡率。进行多因素logistic回归分析以确定死亡率的相关变量。纳入了78例有典型胸部影像学表现的患者，其中50例（64.1%）最初通过胸部X线检查（CXR）发现，而28例（35.9%）最初通过CT发现。此外，85.9%（67/78）在孕龄（GA）<32周的月经后年龄（PMA）36周之前或出生后56天之前被发现（GA>32周）。经过倾向评分匹配后，匹配组由58对患者组成。有典型影像学表现的患者死亡率显著更高（29.3%对12.1%，P = 0.022，OR 3.021），重度BPD的比例更高（32.8%对12.1%，P = 0.003，OR 4.669），出院时HOT的比例更高（74.1%对46.6%，P = 0.002，OR 3.291），高于无典型影像学表现的患者。多因素logistic回归分析显示，BPD早产儿中典型影像学表现≤7天和典型影像学表现>7天是死亡率的独立危险因素（OR 7.794，P = 0.004；OR 4.533，P = 0.001）。应更多关注BPD的胸部影像学表现，尤其是在早期阶段（7天内）。早期识别BPD的发展有助于BPD的早期个体化治疗。ClinicalTrials.gov，标识符：NCT04163822。
