摘要
目的探讨孕母产前应用硫酸镁与早产儿动脉导管未闭（patent ductus arteriosus，PDA）的关系。方法应用1：1配对的病例对照研究方法，对2008年1月至2009年12月在我院新生儿科住院的93例确诊PDA的早产儿（PDA组）和93例胎龄和超声心动图检测时间匹配的动脉导管已关闭的早产儿（对照组）进行回顾性分析，收集孕母产前应用硫酸镁情况及新生儿资料。采用单因素分析、多因素Logistic回归分析等方法进行统计学分析。结果PDA组孕母产前应用硫酸镁51例，而对照组中孕母产前应用硫酸镁34例。PDA组患儿血清镁中位浓度及百分位间距（P25～P75）为0．98mmol／L（0．92～1．32mmol／L），高于对照组[0．90mmol／L（0．82-1．09）mmol／L]，差异有统计学意义（Z=3．56，P=0．00）。Logistic回归分析表明孕母产前应用硫酸镁（OR=2．646，95％CI：1．356～5．163，P=0．004）、胎儿窘迫（OR=7．189，95％CI：1．209～42．756，P=0．030）；早产儿出生体重（OR=1．842，95％CI：1.087～3．438，P=0．049）、呼吸衰竭（OR=3．499，95％CI：1．256～9．752，P=0．017）和吸氧（OR=0．482，95％CI：0．233～0．999，P=0．045）与早产儿PDA的发生有关。而且趋势卡方检验显示，孕母产前应用硫酸镁累积量、血清镁水平与早产儿PDA呈正相关，具有剂量效应关系（Х趋势^2=7．41，P=0．007；Х趋势^2=12．13，P=0．000）。结论孕母产前应用硫酸镁可能增加早产儿发生PDA的风险，且硫酸镁累积量、早产儿血清镁水平越高，早产儿发生PDA的风险越大。
Objective To identify the association between antenatal exposure to magnesium sulfate and patent ductus arteriosus（PDA） in preterm infants. Methods A 1 ： 1 case-control study was conducted on 93 preterm infants with PDA and 93 cases of matched controls without PDA hospitalized in our neonatal intensive care unit between January 2008 and December 2009. Information on antenatal exposure to magnesium sulfate, neonatal birth weight and other perinatal factors was collected and analyzed with univariate analysis, multivariate Logistic regression analysis. Results There were 51 preterm infants exposed to magnesium sulfate antenatally in PDA group and 34 infants in controls. The median （P25-P75） level of neonatal serum magnesium in PDA cases was 0.98 mmol/L （0.92-1.32 mmol/L） ,significantly higher than that in controls [0.90 mmol/L（0. 82-1. 09） mmol/L] （Z = 3.56, P=0.00）. Logistic regression analysis showed that PDA in preterm infants was significantly associated with antenatal magnesium sulfate exposure（OR=2. 646,95 %CI： 1. 356-5. 163, P=0.004）, fetal distress （OR= 7. 189, 95% CI：1.209-42.756, P=0.030）, neonatal birth weight （OR = 1. 842,95 % CI ： 1. 087-3. 438, P = 0. 049 ）, respiratory failure （OR = 3. 499,95 % CI ： 1.256- 9. 752, P=0. 017）and postnatal oxygen inhalation （OR=O. 482,95% CI：0. 233-0. 999, P=0. 045）. Also, a significant positive correlation was found between PDA and the dose of magnesium sulfate and the concentrations of serum magnesium in preterm infants （Хtrend^ 2= 7.41, P= 0. 007 ;Хtrend^ 2 = 12. 13, P= 0. 000）. Conclusions Antenatal exposure to magnesium sulfate might increase the risk of PDA in preterm infants.
出处
《中华围产医学杂志》
CAS
2010年第6期483-487,共5页
Chinese Journal of Perinatal Medicine
关键词
婴儿
早产
动脉导管未闭
硫酸镁
Infant, premature
Ductus arteriosus, patent
Magnesium sulfate
