新生儿持续肺动脉高压死亡危险因素分析

A single-center study on mortality and risk factors in persistent pulmonary hypertension of newborn

目的探讨影响新生儿持续肺动脉高压(PPHN)死亡的危险因素。方法选择2011年1月至2020年10月,中山大学附属江门医院收治的236例PPHN新生儿进行回顾性分析,死亡的25例为观察组,存活的211例为对照组。采用单因素及二元Logistic回归方法分析各临床指标对患儿预后的影响。结果PPHN死亡率为10.6%,单因素分析发现胎粪吸入综合征(MAS),氧合指数(OI)≥16,急性肾损伤(AKI),低血压,是死亡的危险因素(P均<0.05)。二元Logistic回归分析发现OI≥16(OR=4.316;95%CI:1.209~15.415)、AKI(OR=8.656;95%CI:3.062~24.472)和低血压(OR=2.874;95%CI:1.092~7.563)是PPHN死亡的独立危险因素(P<0.05)。结论PPHN死亡率高。OI≥16,AKI和低血压是PPHN死亡的独立危险因素。

Objective To explore the mortality and risk factors for death in persistent pulmonary hypertension of newborn(PPHN).Methods A retrospective study was carried out in 236 PPHN patients in Jiangmen Hospital of Sun Yat sen University.Of the 236 patients,25 dead cases were designated as the experimental group and the other 211 survivals as the control group.Single factor and binary logistic regression analysis were used to investigate the effect of clinical indicators on the prognosis of patients.Results The mortality of PPHN was 10.6%.Univariate analysis showed that the risk factors for death were meconium aspiration syndrome(MAS),oxygenation index(OI)≥16,acute kidney injury(AKI)and hypotension(all P<0.05).Binary logistic regression analysis showed that OI≥16(OR=4.316;95%CI:1.209~15.415),AKI(OR=8.656;95%CI:3.062~24.472)and hypotension(OR=2.874;95%CI:1.092~7.563)were independent risk factors for death in PPHN patients(P<0.05).Conclusion There is a high mortality of PPHN.OI≥16,AKI and hypotension are independent risk factors for death in PPHN patients.