摘要目的 探讨极低及超低出生体重儿支气管肺发育不良(bronchopulmonary dysplasia,BPD)病因及影响因素.方法 回顾性分析2010年1月至2014年12月于中国医科大学附属盛京医院第二新生儿科住院、出生体重≤1200 g、诊断BPD的极低及超低出生体重儿的临床资料,同期住院、同体重非BPD早产儿作为对照组,分析BPD的影响因素及结局.结果 BPD组新生儿128例,平均胎龄(28.6±1.8)周.非BPD组121例,平均胎龄(30.8±1.8)周.BPD组母亲妊高征、胎龄、出生体重、小于胎龄儿均明显低于对照组,产前感染、胎膜早破时间≥18 h、剖宫分娩、男孩、Apgar评分1 min≤3、产时复苏、肺表面活性物质应用、有创机械通气及时间、CPAP及时间、氧疗时间明显高于对照组.多因素logistic逐步回归分析显示,小胎龄(OR=0.492,P<0.05)、男孩(OR=2.771,P<0.05)、有创机械通气(OR=1.014,P<0.05)及CPAP时间久(OR=1.008,P<0.05)促进BPD发生.多因素Logistic回归分析显示Apgar评分1 min≤3(95％CI:1.274～14.017,χ2=5.550,P=0.018,OR=4.226)、有创机械通气时间久(95％CI:1.001～1.004,χ2=10.410,P=0.001,OR=1.003)、PDA手术(95％CI:1.345～129.693,χ2=4.904,P=0.027,OR=13.210)是中重度BPD的独立危险因素.结论 胎龄小、男孩、呼吸支持时间长是BPD发生的危险因素;中重度BPD与Apgar评分1 min≤3、机械通气时间久、PDA手术有关.

abstractsObjective To explore causes and clinical factors associated with bronchopulmonary dyspla-sia( BPD) in very low birth weight infant ( VLBWI) and extremely low birth weight infant( ELBWI) . Methods A retrospective analysis was performed on the clinical data of VLBWI and ELBWI,whose birth weight less than1200g and diagnosed BPD in NICU of Shengjing Hospital between Jan. 1st 2010 and Dec. 31st 2014. No-BPD infants with the same birth weight and during the same period were selected as the control group. Results One handred and twenty-eight cases met the criteria of BPD,whose mean gestational age(GA) was (28. 6 ± 1. 8)weeks. Other 121cases were no-BPD,and mean GA was (30. 8 ± 1. 8)weeks. Maternal hypertension during pregnancy,gestational age,birth weight,small for age infant were lower in BPD group than those in no-BPD group. Prenatal infection,premature rupture of membrances≥18h,cesarean delivery,male,Apgar 1min≤3,intra-partum recovery,alveolar surface active substances,mechanical ventilation and the time,oxygen time were higher in BPD group than those in no-BPD group. Logistic regression analysis indicated that low gestational age( OR=1. 014,P<0. 05),male(OR=2. 771,P<0. 05),duration of invasive mechanical ventilation(OR=1. 014,P<0. 05),duration of CPAP(OR=1. 008,P<0. 05)lead to BPD. Multiple logistic regression model showed that Apgar 1min≤3(95％CI:1. 274～14. 017,χ2 = 5. 550,P=0. 018,OR=4. 226),duration of invasive mechanical ventilation(95％CI:1. 001 ～1. 004,χ2 =10. 410,P =0. 001,OR =1. 003),PDA surgery(95％CI:1. 345 ～129. 693,χ2 =4. 904,P=0. 027,OR=13. 210) were the independent risk factors for the moderate-severe BPD. Conclusion Our study showed that low GA,male,long duration of mechanical ventilation were risk factors of the development of BPD. Apgar 1min≤3,duration of mechanical ventilation,PDA surgery were related with moderate-severe BPD.