中国实用儿科杂志

中国实用儿科杂志 ›› 2024, Vol. 39 ›› Issue (2): 125-129.DOI: 10.19538/j.ek2024020610

• 论著 • 上一篇    下一篇

双胎配对早产儿肺高血压发生的临床资料分析及预后比较

  

  1. 青岛大学附属妇女儿童医院 青岛市妇女儿童医院心脏中心，山东  青岛  266034
  • 出版日期:2024-02-06 发布日期:2024-02-26
  • 通讯作者: 泮思林，电子信箱：silinpan@126.com
  • 基金资助:
    国家自然科学基金项目（82271725）；泰山学者工程资助项目（2018）；青岛市科技惠民示范引导专项（20-3-4-47-nsh）

Analysis of risk factors and prognostic outcomes of twin premature infants with pulmonary hypertension

  1. Heart Center，Women and Children's Hospital，Qingdao University，Qingdao  266034，China
  • Online:2024-02-06 Published:2024-02-26

摘要： 目的    探讨早产儿肺高血压（PH）发生的临床资料及预后情况。方法    回顾性分析2016年1月至2022年6月青岛大学附属妇女儿童医院收治的仅1胎发生PH的双胎早产儿临床资料，将其分为PH组和对照组。比较两组之间的一般资料（出生体重、性别、出生顺序等）、临床资料（呼吸机支持时间、并发症、实验室检查等）及随访结果。结果    研究纳入符合入选标准的双胎早产儿共33对。与对照组相比，PH多发生于双胎之次、小于胎龄儿、呼吸支持时间和住院时间长的患儿（P < 0.05）。两组患儿在并发症方面比较，新生儿持续性肺动脉高压、败血症、新生儿窒息、脑室内出血、新生儿呼吸窘迫综合征及先天性心脏病差异无统计学意义（P > 0.05），PH组中-重度支气管肺发育不良的发生率明显高于对照组（P < 0.05）。两组患儿生后初次血气分析、血常规及生化指标均差异无统计学意义（P > 0.05）。PH组16例患儿生后早期接受降肺动脉压药物及强心、利尿药物治疗，中位随访时间5.25年，期间无患儿死亡。6月龄时39.4%（13/33）的患儿PH恢复正常，1岁时81.8%（27/33）恢复正常。结论    该研究以双胎早产儿为研究对象，对早产儿PH的临床资料进行对比研究发现，生后早期病情危重，呼吸机支持时间及住院时间长可能是导致早产儿发生PH的重要因素，且与中-重度支气管肺发育不良的发生有关。81.8%的PH早产儿在生后1年内恢复正常。

关键词: 双胎, 早产儿, 肺高血压, 随访

Abstract: Objective    To analyze and summarize the risk factors and prognostic outcomes of pulmonary hypertension （PH） in premature infants. Methods    The twins admitted to Women and Children's Hospital，Qingdao University，from January 2016 to June 2022 were taken as the research subjects. One of the twins was diagnosed with PH，and comparison of paired twins. The clinical data，risk factors and follow-up results were analyzed retrospectively. Results    In this study，33 pairs of premature twins with PH were included. Compared to the control，a higher frequency of PH was observed in Twin's second and were small in terms of the age of gestation，the duration of respiratory support and the length of hospital stays （P<0.05）. There was no significant statistical difference in the prevalence of complications between the children of the two groups，such as persistent pulmonary hypertension，sepsis，neonatal asphyxia，intraventricular hemorrhage，neonatal respiratory distress syndrome，and congenital heart disease （P>0.05）. The incidence of moderate to severe BPD was higher in the PH group （P<0.05）. There were no significant differences in laboratory indicators between the two groups concerning the initial blood gas analysis， blood routine tests and bio-markers（P>0.05）. In the PH group，16 children were given early postoperative drugs to decrease pulmonary hypertension，as well as cardiotonic and diuretic medicines. The median follow-up time was 5.25 years，and there were no deaths during this period. At the age of 6 months ，PH of 39.4% （13/33） returned to normal，and at 1 year old，81.8% （27/33） returned to normal. Conclusion    This study takes premature twins as research subjects and compares the clinical date of PH in premature twins. The critical condition of early post-natal development，the use of a ventilator and the prolonged hospitalisation are factors that contribute to the development of premature infant PH，which is related to a moderate-to-severe BPD. 81.8% of premature infants with PH return to normal within one year after birth.

Key words: twins, premature infant, pulmonary hypertension, follow-up