摘要
目的探讨Apgar评分联合降钙素原(PCT)对宫内感染性肺炎新生儿预后的预测价值。方法选取2018年1月至2021年11月期间于安庆市第一人民医院新生儿病房住院的宫内感染性肺炎新生儿114例。根据新生儿存活情况,将114例宫内感染性肺炎新生儿分为死亡组(n=18)和存活组(n=96)。比较2组产妇和新生儿的一般情况。利用Cox比例风险回归筛选宫内感染性肺炎新生儿死亡危险因素,基于这些危险因素构建预测宫内感染性肺炎新生儿死亡概率的列线图模型,并对模型进行评价。结果母亲产前发热、胎膜早破、母亲合并妊娠糖尿病(GDM)、出生1 min Apgar评分、血清淀粉样蛋白A(SAA)、PCT均是宫内感染性肺炎新生儿预后死亡的危险因素(P<0.05)。列线图模型预测宫内感染性肺炎新生儿死亡的概率为75%。列线图模型的区分度和准确性均较高。出生1 min Apgar评分+PCT+SAA和母亲产前发热+胎膜早破+母亲合并GDM+出生1minApgar评分+SAA+PCT对宫内感染性肺炎新生儿死亡的预测价值相当,且均大于各研究指标单独对死亡的预测价值。结论母亲产前发热、胎膜早破、出生1 min Apgar评分、母亲合并GDM、SAA、PCT均是宫内感染性肺炎新生儿预后死亡的危险因素。出生1minApgar评分联合PCT和SAA对宫内感染性肺炎新生儿死亡风险有较好的预测价值。
Objective To analyze the value of Apgar score combined with procalcitonin(PCT)in predicting the prognosis of newborns with intrauterine infectious pneumonia.Methods 114 newborns with intrauterine infectious pneumonia who were hospitalized in the neonatal ward of the Anqing First People’s Hospital from January 2018 to November 2021 were selected.According to the survival of newborns,114 newborns with intrauterine infectious pneumonia were divided into death group(n=18)and survival group(n=96).The general conditions of parturients and newborns of the two groups were compared.Cox proportional hazard regression model was used to screen the risk factors of neonatal death caused by intrauterine infectious pneumonia.Based on these risk factors,the Nomogram model was constructed to predict the neonatal death probability of intrauterine infectious pneumonia,and the model was evaluated.Results Maternal fever,premature rupture of membranes,mother with GDM,1-minute Apgar score,serum amyloid A(SAA)and PCT were all risk factors for prognosis and death of newborns with intrauterine infectious pneumonia(P<0.05).The probability of predicting neonatal death from intrauterine infectious pneumonia by the Nomogram model is 75%.The discrimination and accuracy of the Nomogram model are high.The predictive value for neonatal death of intrauterine infectious pneumonia of 1-minute Apgar score+PCT+SAA was similar with that of maternal prenatal fever+premature rupture of membranes+mother with GDM+1-minute Apgar score+SAA+PCT,and were higher than that of each research index alone.Conclusion Maternal prenatal fever,premature rupture of membranes,maternal complicated with GDM,1-minute Apgar score,SAA and PCT are all risk factors for prognosis and death of newborns with intrauterine infectious pneumonia.1-minute Apgar score combined with PCT and SAA has a good predictive value for the risk of neonatal death in patients with intrauterine infectious pneumonia.
作者
朱芳艮
余静
ZHU Fanggen;YU Jing(Department of Pediatrics,Anqing First People's Hospital,Anqing,Anhui 246000,China;Department of Pediatrics,Anhui Children's Hospital,Hefei,Anhui 230022,China)
出处
《中国优生与遗传杂志》
2023年第1期119-124,共6页
Chinese Journal of Birth Health & Heredity
