早产儿肺出血预后不良的相关因素分析

Clinical analysis on risk factors to the poor prognosis of preterm pulmonary hemorrhage

目的:研究早产儿肺出血预后不良的相关因素。方法:选取武汉大学中南医院2015年1月~2018年6月诊断为肺出血的早产儿31例为研究对象,分为存活组(15例)和死亡组(16例),收集患儿及母亲围产期情况,分析其对预后的影响。结果:单因素分析,剖宫产、低体质量、小于胎龄儿,血清白蛋白降低、凝血酶原时间及凝血酶时间延长、降钙素原升高均为早产儿肺出血死亡的危险因素(P<0.05,P<0.01)。二分类Logistic回归分析显示血清白蛋白降低(OR=0.217,95%CI:0.007~0.675)、凝血酶时间延长(OR=3.093,95%CI:1.771~6.211)、降钙素原升高(OR=3.477,95%CI:2.335~51.833)均为早产儿肺出血死亡的独立危险因素。ROC曲线分析提示血清白蛋白<26.45 g/L、凝血酶时间>21.30 s、降钙素原>3.35 ng/mL可用于预测早产儿肺出血死亡(P<0.05,P<0.01)。结论:血清白蛋白低、凝血酶时间延长、降钙素原高为早产儿肺出血死亡的危险因素,对其预后有预测价值。

Objective:To observe the risk factors of poor prognosis in preterm pulmonary hemorrhage.Methods:The study was performed in 31 prematures with pulmonary hemorrhage diagnosed in Zhongnan Hospital of Wuhan University between January 2015 and June 2018.They were divided into survival group(15 cases)and death group(16 cases).The relationship between clinical characteristics of mothers and prematures with prognosis of pulmonary hemorrhage was analyzed.Results:The results of univariate analysis revealed that cesarean section,low weight,small for gestational,low serum albumin,prothrombin time extension,thrombin time extension and high procalcitonin were the risk factors for the death of pulmonary hemorrhage cases(P<0.05,P<0.01).Logistic analysis revealed that low serum albumin(OR=0.217,95%CI:0.007-0.675),thrombin time extension(OR=3.093,95%CI:1.771-6.211)and high procalcitonin(OR=3.477,95%CI:2.335-51.833)were independent risk factors.ROC curve analysis revealed that serum albumin<26.45 g/L,thrombin time>21.30 s,procalcitonin>3.35 ng/mL could predict the death of preterm pulmonary hemorrhage(P<0.05 or P<0.01).Conclusion:Low serum albumin,thrombin time extension and high procalcitonin are risk factors of the death of preterm pulmonary hemorrhage and are valuable in prognosis.