早产儿中重度支气管肺发育不良与出生后早期动脉血气值的相关性

韩晓雅; 赵益伟; 缪晓林; 崔曙东

doi:10.12025/j.issn.1008-6358.2022.20211861

早产儿中重度支气管肺发育不良与出生后早期动脉血气值的相关性

The relationship between early postnatal arterial blood values and moderate and severe bronchopulmonary dysplasia in preterm infants

摘要

摘要:
目的探讨胎龄小于32周早产儿中重度支气管肺发育不良（bronchopulmonary dysplasia, BPD）与生后早期动脉血pH值、PaO₂及PaCO₂的相关性。
方法收集2017年1月至2019年12月南京医科大学第一附属医院新生儿病房胎龄小于32周的236例早产儿的临床资料，其中54例中重度BPD为BPD组，其余为对照组。分析早产儿生后1周内动脉血pH值、PO₂及PCO₂与中重度BPD的关系。
结果出生后第1天，BPD组pH值显著低于对照组（7.25±0.12）vs（7.31±0.09），P=0.001；出生后第7天，BPD组PaO₂显著低于对照组（63.20±23.75）mmHg vs（75.91±20.70）mmHg，1 mmHg=0.133 kPa，P < 0.001，PaCO₂显著高于对照组（43.59±9.87）mmHg vs（38.26±9.11）mmHg，P < 0.001。除了低胎龄、低出生体质量和机械通气外，出生后第1天的低pH值和第7天的低PaO₂是中重度BPD的独立危险因素。
结论早产儿生后早期低pH值和低PaO₂可能影响中重度BPD进展。

Abstract:
Objective To study the relationship between arterial blood pH, PaO₂, and PaCO₂ in the first week after birth and moderate and severe bronchopulmonary dysplasia (BPD) in preterm infants.
Methods A cohort of 236 consecutive preterm infants with < 32 gestational weeks were selected from January of 2017 to December of 2019, 54 infants with moderate and severe BPD were identified as the study group and the other as the control group. Early blood gas values and clinical characteristics were collected and analyzed.
Results Compared with the control group, significantly lower pH (7.25±0.12 vs 7.31±0.09, P=0.001) of 1st day, lower PaO₂ (63.20±23.75 mmHg vs 75.91±20.70 mmHg, P < 0.001), higher PaCO₂ (43.59±9.87 mmHg vs 38.26±9.11 mmHg, 1 mmHg=0.133 kPa, P < 0.001) of 7th day occurred in the study group. Lower pH of 1st day and lower PaO₂ of 7th day after birth were the independent risk factors of moderate and severe BPD besides lower gestational age, lower birth weight, and mechanical ventilation.
Conclusions The early hypoxia and acidosis after birth may affect the progress of moderate and severe BPD.

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