胎龄〈34周呼吸窘迫综合征早产儿纠正年龄40周时肺功能监测

Measurement of tidal respiration in 〈 34 weeks premature infants with respiratory clistress syndrome at 40 weeks corrected gestational age

目的探讨〈34周呼吸窘迫综合征早产儿纠正年龄40周时潮气呼吸肺功能的情况及其影响因素。方法收集2013年12月至2015年10月在青岛市妇女儿童医院住院，且出院后随访至纠正年龄12个月的〈34周RDS早产儿49例（为RDS组）、〈34周非RDS早产儿36例（为非RDS组），两组早产儿在纠正年龄40周时分别有35例、20例完成潮气呼吸肺功能监测，以同期因新生儿高胆红素血症住院的足月儿26例（为足月儿组），比较3组患儿潮气呼吸肺功能各项指标的差异。RDS组根据病情严重程度分为轻度RDS组与重度RDS组。结果①RDS组TPEF[（0.17±0.04）s vs.（0.23±0.09）s]、VPEF[（6.74±2.70）mL vs.（9.33±2.92）mL]、TPEF/TE[（29.06±4.21）% vs.（38.27±7.16）%]、VPEF/VE[（32.54±4.43）% vs.（39.64±5.88）%]低于足月儿组，差异具有统计学意义（P〈0.05）；非RDS组TPEF[（0.19±0.06）s vs.（0.23±0.09）s]、TPEF/TE[（30.31±11.53）% vs.（38.27±7.16）%]、VPEF/VE[（34.39±8.44）% vs.（39.64±5.88）%]低于足月儿组，差异具有统计学意义（P〈0.05）；RDS组TPEF、TPEF/TE、VPEF/VE低于非RDS组，但差异无统计学意义（P〉0.05）。②轻度RDS组TPEF、VPEF、TPEF/TE、VPEF/VE高于重度RDS组，但差异无统计学意义（P〉0.05）。③Logistic回归分析：出生胎龄为影响RDS早产儿肺功能的保护性因素。结论〈34周RDS早产儿在纠正胎龄40周时小气道阻力仍高于足月儿，〈34周RDS早产儿与〈34周非RDS早产儿在纠正年龄40周时的肺功能差异无统计学意义，出生胎龄为RDS早产儿肺功能的影响因素。

ObjectiveTo investigate pulmonary function in terms of tidal respiration and the influencing factors on it in 〈34 weeks premature infants with RDS at corrected gestational age of 40 weeks.MethodsA total of 49 of 〈34 weeks premature infants with RDS （RDS group） and 36 of 〈34 weeks premature infants without RDS （non-RDS group） followed throughout entire twelve months were collected from December 2013 to October 2015.Of them, 35 RDS patients and 20 non-RDS patients had the pulmonary function examination .A total of 26 full term infants with hyperbilirubinemia （full term group） were recruited for comparison study. The differences in parameters of tidal respiration were compared among the three groups. The RDS patients were further divided into the mild RDS subgroup and severe RDS subgroup according to the severity of illness.Result①The TPEF [（0.17±0.04）s vs.（0.23±0.09）s], VPEF [（6.74±2.70）mL vs.（9.33±2.92）mL], TPEF/TE [（29.06±4.21）% vs. （38.27±7.16）%], VPEF/VE [（32.54±4.43）% vs. （39.64±5.88）%] in RDS group were significantly lower than those in full term group （P〈0.05）. The TPEF [（0.19±0.06）s vs. （0.23±0.09）s], TPEF/TE[（30.31±11.53）% vs. （38.27±7.16）%], VPEF/VE [（34.39±8.44）% vs. （39.64±5.88）%] in non-RDS group were significantly lower than those in full term group （P〈0.05）. The TPEF, TPEF/TE, VPEF/VE in RDS group were lower than those in non-RDS group, but the differences were not significant （P〉0.05）. ②The TPEF, VPEF, TPEF/TE, VPEF/VE in mild RDS group were higher than those in severe RDS group, but the differences were not significant （P〉0.05）. ③Logistic regression analysis indicated that the gestational age was the protective factor of pulmonary function in premature infants with RDS.ConclusionsSmall airway resistance in 〈34 weeks premature infants with RDS is higher than that in full term infants. There was no significant difference in pulmonary function between RDS premature infants and non-RDS premature infants. The gestational age was the influencing factor of pulmonary function in premature infants with RDS.