文章摘要
陆彬彬,丁 蓉,郭丽敏,管亚飞,陈筱青,崔曙东,陆 超.早产儿与足月儿肺动脉高压的原发疾病调查[J].南京医科大学学报,2020,(12):1829~1833
早产儿与足月儿肺动脉高压的原发疾病调查
Investigations of primary diseases of pulmonary hypertension in preterm and full ⁃ term neonates
投稿时间:2020-05-30  
DOI:10.7655/NYDXBNS20201217
中文关键词: 新生儿肺动脉高压  早产儿  足月儿  危险因素
英文关键词: pulmonary hypertension of neonates  premature infants  full⁃term infants  risk factor
基金项目:国家自然科学基金面上项目(81770162)
作者单位
陆彬彬 南京医科大学第一附属医院儿科江苏 南京 210029 
丁 蓉 南京医科大学第一附属医院儿科江苏 南京 210029 
郭丽敏 南京医科大学第一附属医院儿科江苏 南京 210029 
管亚飞 南京医科大学第一附属医院儿科江苏 南京 210029 
陈筱青 南京医科大学第一附属医院儿科江苏 南京 210029 
崔曙东 南京医科大学第一附属医院儿科江苏 南京 210029 
陆 超 南京医科大学第一附属医院儿科江苏 南京 210029 
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中文摘要:
      目的:探讨新生儿肺动脉高压的相关高危因素。方法:收集近3年南京医科大学第一附属医院儿科收治的肺动脉高压新生儿41例,分为足月儿组和早产儿组,回顾性分析了两组的临床资料与新生儿肺动脉高压的关系。结果:早产儿组23例,足月儿组18例。早产儿组胎膜早破、胎盘早剥、绒毛膜羊膜炎、子痫的发生率高于足月儿组,差异有统计学意义(P<0.05)。足月儿组的孕母妊娠期糖尿病5例(占27.8%),早产儿组孕母妊娠期糖尿病共1例(占4.3%),与足月儿组比较,差异有统计学意义(χ2=4.437,P=0.035)。与足月儿组相比,早产儿组的原发病以呼吸窘迫综合征为主(χ2=19.158,P<0.001),容易合并肺出血(χ2=4.433,P=0.035)、颅内出血(χ2=8.715,P=0.003)。足月儿组原发疾病主要为先天性心脏病(室间隔缺损)(χ2=10.786,P=0.001)。新生儿肺炎在两组均有较高发生率,但差异无统计学意义(χ2=0.327,P>0.05)。两组之间并发代谢性酸中毒、新生儿低血糖、气胸、败血症等统计比较,差异无统计学意义(P>0.05)。早产儿组治愈21例,死亡2例,足月儿组治愈15例,死亡3例,治疗效果两组比较差异无统计学意义(P>0.05)。结论:早产儿肺动脉高压的高危原发疾病是呼吸窘迫综合征、重症肺炎、肺出血以及孕母有胎膜早破、胎盘早剥等并发症;患有先天性心脏病如室间隔缺损的足月儿,要重视可能伴有的肺动脉高压并及时诊治。
英文摘要:
      Objective:This study aims to investigate the risk factors of pulmonary hypertension in neonates. Methods:From January 2017 to December 2019,41 neonates with pulmonary hypertension admitted to the neonatal ward of the First Affiliated Hospital of Nanjing Medical University were collected and divided into preterm neonate group and full?term neonate group according to their gestational ages. The relationship between pulmonary hypertension and high risk factors such as primary disease and maternal high risk factors during pregnancy were analyzed retrospectively. Results:During the indicated three years,1 992 premature infants and 3 394 full?term infants were collected. Among them,23 premature(1.15%) and 18 full?term infants(0.53%) with pulmonary hypertension were included. There were significant differences in birth weight and gestational age between the two groups(P < 0.05). No statistical differences in maternal age,gender,mode of delivery,twin or multiple births,and Apgar scores between the two groups(P > 0.05). The incidences of premature rupture of membranes,placental abruption,chorioamnionitis and eclampsia in preterm group were higher than those in full?term group(P < 0.05). The differences were statistically significant in the incidences of gestational diabetes mellitus between the two groups(5 cases in full?term group vs. 1 case in preterm group,χ2=4.437,P=0.035). Compared with the full?term group,the major primary disease of preterm group was respiratory distress syndrome(χ2=19.158,P<0.001),pulmonary hemorrhage(χ2=4.433,P=0.035)and intracranial hemorrhage(χ2=8.715,P=0.003),respectively. The primary disease in full?term group was mainly congenital heart disease(ventricular septal defect)(χ2=10.786,P=0.001). There was a high occurence rate of neonatal pneumonia in both groups,but no statistical difference was shown(χ2=0.327,P > 0.05). There were no statistical differences in metabolic acidosis,neonatal hypoglycemia,pneumothorax and septicemia between the two groups(P > 0.05). In preterm group,21 cases were cured and 2 cases died. 15 cases were cured and 3 cases died in full?term group. No statistical difference was found in treatment effect between the two groups(P > 0.05). Conclusion:The high?risk primary diseases of pulmonary hypertension in premature infants included respiratory distress syndrome,severe pneumonia,pulmonary hemorrhage,premature rupture of membranes and placental abruption. For full?term infants with congenital heart disease such as ventricular septal defect,timely diagnosis and treatment against pulmonary hypertension should be paid more attentions.
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