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支气管肺发育不良早产儿的神经发育结局

Neurodevelopmental outcome of preterm infants with bronchopulmonary dysplasia.

作者信息

Gray P H, Burns Y R, Mohay H A, O'Callaghan M J, Tudehope D I

机构信息

Mater Misericordiae Hospitals, South Brisbane, Queensland, Australia.

出版信息

Arch Dis Child Fetal Neonatal Ed. 1995 Nov;73(3):F128-34. doi: 10.1136/fn.73.3.f128.

Abstract

The neurodevelopmental outcome of 78 infants with bronchopulmonary dysplasia (BPD) was compared with that of 78 control infants matched for birthweight. To determine the effect of the severity of BPD, 62 infants requiring oxygen at 36 weeks' postmenstrual age (sBPD) were compared with their matched controls. Infants were followed up to 2 years of age, corrected for prematurity, and were classified for neurological impairment, developmental delay, and neurodevelopmental disability. Seventy six (98%) BPD infants and 71 (91%) controls had follow up data available to two years. Neurological impairment, developmental delay, and neurodevelopmental disability occurred more frequently in infants with BPD than in controls but this was not significant. For infants with sBPD, the increased incidence of neurological impairment and definite developmental delay was not significant when compared with the controls, though neurodevelopmental disability occurred more frequently (odds ratio (OR) 3.6: 95% confidence intervals (CI) 1.1-11.8). Predictors of disability in infants with sBPD included periventricular haemorrhage (OR 19.4: 95% CI 4.3-86.6), ventricular dilatation (OR 12.8: 95% CI 2.9-57.3), and sepsis (OR 5.0: 95% CI 1.3-19.4). Adjusting for the presence of these factors, the association between BPD and disability was no longer apparent (OR 0.9: 95% CI 0.2-3.6). The findings suggest that BPD is not independently associated with adverse neurodevelopmental outcome.

摘要

将78例支气管肺发育不良(BPD)婴儿的神经发育结局与78例出生体重匹配的对照婴儿进行比较。为确定BPD严重程度的影响,将62例在孕龄36周时仍需吸氧的婴儿(重度BPD,sBPD)与其匹配的对照进行比较。婴儿随访至2岁(矫正早产因素),并对神经损伤、发育迟缓及神经发育残疾进行分类。76例(98%)BPD婴儿和71例(91%)对照婴儿有至2岁的随访数据。BPD婴儿中神经损伤、发育迟缓及神经发育残疾的发生率高于对照婴儿,但差异无统计学意义。对于sBPD婴儿,与对照相比,神经损伤和明确发育迟缓的发生率增加无统计学意义,尽管神经发育残疾的发生率更高(比值比(OR)3.6:95%置信区间(CI)1.1 - 11.8)。sBPD婴儿残疾的预测因素包括脑室周围出血(OR 19.4:95% CI 4.3 - 86.6)、脑室扩张(OR 12.8:95% CI 2.9 - 57.3)及败血症(OR 5.0:�5% CI 1.3 - 19.4)。校正这些因素后,BPD与残疾之间的关联不再明显(OR 0.9:95% CI 0.2 - 3.6)。研究结果表明,BPD与不良神经发育结局无独立关联。

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