支气管肺发育不良并发早产儿视网膜病的临床影响因素分析

Analysis of clinical factors influencing bronchopulmonary dysplasia complicating retinopathy of prematurity

目的探讨支气管肺发育不良(BPD)早产儿并发早产儿视网膜病(ROP)的临床影响因素。方法选取2016年1月至2021年12月于苏州大学附属儿童医院新生儿科住院治疗、出生胎龄<32周并诊断为BPD的230例早产儿为研究对象,根据眼底筛查结果分为ROP组(n=60)和对照组(n=170)。对比两组患儿临床因素的差异性,探讨BPD早产儿并发ROP的临床影响因素。结果本研究230例BPD早产儿轻度、中度、重度分别为108、81、41例;ROP组患儿胎龄、出生体重低于对照组,差异具有统计学意义(t值分别为-5.100、-3.743,P<0.001);ROP组吸氧时间、早期输血(生后10天内)比例及28天内输血次数高于对照组,差异有统计学意义(χ^(2)/Z值分别为-2.745、25.336、-5.899,P<0.05);多因素Logistic回归结果显示,生后早期输血、生后28天输血次数多是BPD早产儿发生ROP的独立危险因素,其OR值及95%CI分别为4.371(1.981~7.757)、3.563(2.032~6.246);胎龄是BPD早产儿发生ROP的保护因素,模型1及模型2的OR值及95%CI分别为0.715(0.541~0.946)、0.717(0.538~0.956)。结论BPD患儿胎龄小、体重轻、吸氧时间长易并发ROP,生后早期输血、28天内输血次数多也需警惕BPD及ROP的发生。

Objective To investigate the clinical factors affecting retinopathy of prematurity(ROP)complicated by bronchopulmonary dysplasia(BPD)in preterm infants.Methods A total of 230 premature infants with gestational age<32 weeks and diagnosed with BPD who were hospitalized in the Department of Neonatology,Children s Hospital of Soochow University from January 2016 to December 2021 were selected as the study subjects,and were divided into ROP group(n=60)and control group(n=170)according to the results of fundus screening.The difference of clinical factors between the two groups was compared to explore the clinical influencing factors of premature BPD complicated with ROP.Results The 230 BPD preterm infants in this study were 108,81,and 41 cases of mild,moderate,and severe,respectively.The gestational age and birth weight of infants in ROP group were lower than those in control group,and the differences were statistically significant.(t=-5.100 and-3.743,respectively,P<0.001).The duration of oxygen intake,the proportion of early blood transfusion(within 10 days of birth),and the number of transfusions in the 28-day period in the ROP group were higher than those of the control group,and the difference was statistically significant.(χ^(2)/Z=-2.745,25.336 and-5.899,respectively,P<0.05).Multivariate Logistic regression showed that the early blood transfusion and high number of blood transfusions at 28 days after birth were independent risk factors for ROP in premature infants with BPD,and the OR and 95%CI were 4.371(1.981-7.757)and 3.563(2.032-6.246),respectively.Gestational age was a protective factor for ROP in preterm infants with BPD.The OR values and 95%CI of Model 1 and Model 2 were 0.715(0.541-0.946)and 0.717(0.538-0.956),respectively.Conclusion BPD children with small gestational age,low birth weight and long term of oxygen inhalation are prone to requiring ROP,and special attention should be paid to the BPD children who have early transfusion and frequent blood transfusions within 28 days.