早产儿脑室周围白质软化的多因素分析

Multiple-factor analysis of periventricular leukomalacia in preterm infants.

目的 探讨早产儿脑室周围白质软化 (PVL)的高危因素。方法 对合并PVL与未合并PVL的早产儿(各 2 6例 )进行病例对照研究 ,对 18种危险因素进行Logistic回归分析。结果 胎膜早破 (PROM )、生后 4h内的pH值、动脉氧分压、生后 3d内最低二氧化碳分压、生后第 1周超声发现脑室周围强回声团 (PVE)的OR值分别为 2 383、3 2 77、3 76 9、3 96 5、1 931(P <0 0 1)。建立的早产儿PVL主效应模型为Logit(P) =β0 +0 897PROM - 1 346PaO2 - 1 2 78pH - 1 4 6 7PaCO2 +0 792PVE(χ2 =2 1 378,P =0 0 0 1)。结论 PROM、低氧血症、酸中毒、低碳酸血症、PVE为早产儿PVL的高危因素。

Objective To investigate the high risk factors of periventricular leukomalacia(PVL) in preterm infants.Methods A total of 52 preterm infants with and without PVL were analysed by case control study.Logistic regression analysis for 18 kinds of risk factors was also made.Results Odds ratios of premature rupture of membranes(PROM),pH value within the first 4 hours of life,PaO 2 within the first 4 hours of life,the lowest PaCO 2 within the first 3 days of life and periventricular echodensity(PVE) within the first week of life were 2 383,3 277,3 769,3 965 and 1 931 respectively(P<0 01).The logistic regression equation of PVL risk factors was logit(P)= β 0+0 897PROM-1 346PaO 2-1 278pH-1 467PaCO 2+0 792PVE(χ 2=21 378,P=0 001).Conclusion PROM,hypoxemia,acidosis,hypocarbia and PVE are high risk factors of PVL.