早产儿脑室周围白质软化的相关因素

Etiologic factors of the periventricular leukomalacia in preterm infants

目的探讨早产儿脑室周围白质软化(periventricular leukomalacia,PVL)发病相关因素及临床特点。方法以2005年8月至2006年12月在本院住院的214例早产儿为研究对象,调查其胎龄、体重、出生情况,通过床旁颅脑彩超确诊PVL,记录PVL临床表现、彩超结果,并与同期入院无PVL早产儿进行比较。结果1胎龄与PVL发生有关(χ2=72.52,P<0.05);2出生体重与PVL发生有关(χ2=31.35,P<0.05);3重度窒息早产儿PVL发病率高,但Apgar评分与PVL发生无关(χ2=4.00,P>0.05);4PVL多在生后10d内确诊,无明显临床表现。结论胎龄、出生体重与早产儿PVL的发生呈线性关系;Apgar评分高、低与早产儿PVL的发生并无明显关联;多数早产儿PVL无明显临床表现;床旁颅脑超声是早期诊断危重早产儿PVL的可靠、敏感和方便的手段。

Objective To analyze the etiologic factors and clinical manifestation of the periventricular leukomalacia （PVL） in preterm infants. Methods 214 preterm infants from August 2005 to December 2006 were accrued to investigate their gestational age, birth weight, birth history, and clinical symptoms. Cranial chromatic ultrasound was used to scan the preterm infants and diagnose PVL. Results ①The incidence of PVL was associated with gestational age. The earlier the gestational age of infants, the higher the incidence of PVL occurred （Х^2=72.52, P〈0.05）. ② The incidence of PVL was also associated with birth weight. The lower the birth weight of infants, the higher the incidence of PVL was observed（Х^2= 31. 35, P〈0.05）. ③PVL occurred more frequently ifi infants with severe asphyxia than in those with mild asphyxia, but the incidence of PVL was not associated with Apgar score（3（Х^2= 4.00, P〉0.05）. ④PVL usually had mild clinical manifestations and was diagnosed within 10 days after birth. Conclusions Early gestational age, low birth weight were risk factors for PVL. Apgar score was not significantly associated with PVL. The clinical symptoms of PVL are usually mild in most patients. Cranial chromatic ultrasound is a reliable, sensitive and convenient method of early detection for PVL in critically ill preterm infants.