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血细胞比容预测极低出生体重早产儿支气管肺发育不良的价值。

The value of hematocrit for predicting bronchopulmonary dysplasia in very low birth weight preterm infants.

机构信息

Department of Neonatology, Shenzhen Maternity and Child Healthcare Hospital, Cheeloo College of Medicine, Shandong University, Shenzhen, China.

Department of Neonatology, The First Affiliated Hospital of USTC, Hefei, China.

出版信息

Medicine (Baltimore). 2023 Sep 29;102(39):e35056. doi: 10.1097/MD.0000000000035056.

Abstract

To determine hematocrit (HCT) and to identify independent risk factors for predicting bronchopulmonary dysplasia (BPD) in preterm infants with very low birth weight (VLBW) infants. This retrospective study included 296 premature infants with VLBW in the neonatal intensive care unit of the First Affiliated Hospital of the University of Science and Technology of China between January 2015 and December 2019. Maternal pregnant information and clinical information as well as hematological parameters of preterm babies were collected and compared. Then the maximum area under the curve of receiver operating characteristic curve was developed to estimate the predictive indicator in the blood. Finally, differential variables together with the predictive index were screened for multiple logistic regression analysis to determine independent prognostic factors for BPD. Infants were divided into a BPD group (134 cases) and a non-BPD group (162 cases). The area under the curve of HCT at postnatal 1 week was 0.737 with the sensitivity of 52.30 % and the specificity of 86.00%. Birth weight (BW) <1.12 kg, gestational age <28.4 weeks, newborn respiratory distress syndrome, mechanical ventilation ≥ 7 days, ventilation associated pneumonia, patent arterial duct, PaO2/FiO2 <300 mm Hg and HCT <0.455 at postnatal 1 week were risk factors for BPD of VLBW infants. HCT levels below 0.455 at 1 week after birth serve as a valuable indicator for the potential development of BPD.

摘要

目的

确定血细胞比容(HCT),并识别预测极低出生体重(VLBW)早产儿支气管肺发育不良(BPD)的独立危险因素。

方法

本回顾性研究纳入了 2015 年 1 月至 2019 年 12 月在安徽医科大学第一附属医院新生儿重症监护病房收治的 296 例 VLBW 早产儿。收集并比较了产妇妊娠信息、临床资料以及早产儿的血液学参数。然后,绘制受试者工作特征曲线下面积最大的曲线,以评估血液中的预测指标。最后,对差异变量和预测指标进行多因素逻辑回归分析,以确定 BPD 的独立预后因素。

结果

根据有无 BPD 将患儿分为 BPD 组(134 例)和非 BPD 组(162 例)。HCT 对 1 周后 BPD 的曲线下面积为 0.737,敏感度为 52.30%,特异度为 86.00%。BW<1.12 kg、GA<28.4 周、新生儿呼吸窘迫综合征、机械通气≥7 天、呼吸机相关性肺炎、动脉导管未闭、PaO2/FiO2<300 mm Hg、HCT<0.455 是 VLBW 患儿发生 BPD 的危险因素。出生后 1 周 HCT<0.455 是发生 BPD 的独立危险因素。

结论

HCT 水平对预测 VLBW 早产儿发生 BPD 有一定价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61f5/10545317/4de24f886c29/medi-102-e35056-g001.jpg

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