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目的探讨早产儿动脉导管未闭(PDA)的危险因素。方法对2010年7月至2011年7月在我院新生儿监护病房住院的早产儿进行回顾性研究。其中出生48h后进行超声检查诊断PDA的患儿为病例组,按2.5∶1的比例从动脉导管关闭的早产儿中随机抽取对照组。将两组早产儿的产科合并症、宫内情况、早产儿相关疾病、生后干预及相关检验指标进行对照研究。单因素分析中有统计学意义的因素进行Logistic回归分析。结果共纳入病例组96例,对照组250例。单因素分析显示胎龄、出生体重、母亲产前用药情况、早产儿相关疾病及生后干预与PDA相关。趋势卡方检验等级效应分析显示,胎龄越小,出生体重越低,PDA发生率越高,Logistic回归分析提示感染和暂时性甲状腺功能低下是PDA的独立危险因素,胎龄为独立保护因素(OR值分别为2.183、2.935和0.806),P均<0.05。结论本研究中,早产儿PDA与小胎龄、低出生体重、合并感染及暂时性甲状腺功能低下密切相关。
Objective To explore the risk factors of patent ductus arteriosus (PDA) in preterm infants. Methods A retrospective study was conducted on premature infants admitted to neonatal intensive care unit in our hospital from July 2010 to July 2011. Among them, 48 hours after birth, children diagnosed with PDA underwent sonography as the case group. The control group was randomly selected from 2.5% of the premature infants with patent ductus arteriosus closure. The two groups of obstetric complications of preterm children, intrauterine conditions, premature children related diseases, postnatal interventions and related test indicators for controlled study. Logistic regression analysis showed that statistically significant factors in univariate analysis. Results A total of 96 cases were included in the case group and 250 cases in the control group. Univariate analysis showed gestational age, birth weight, maternal prenatal medication, premature infant-related and postnatal interventions associated with PDA. Trend chi-square test grade effect analysis showed that the smaller the gestational age, the lower the birth weight, the higher the incidence of PDA, Logistic regression analysis suggested that the infection and temporary hypothyroidism are independent risk factors for PDA, gestational age as an independent protective factor OR values were 2.183,2.935 and 0.806 respectively), P <0.05. Conclusions In this study, PDA in preterm infants was closely related to gestational age, low birth weight, co-infection and temporary hypothyroidism.