目的:探讨毛细血管渗漏综合征(CLS)发生的危险因素。方法:回顾性分析52例发生CLS患儿(病例组)的临床资料,另选取50例未发生CLS的住院新生儿作为对照组。对CLS发生的因素进行单因素分析,应用多元logistic 回归分析确定与 CLS 相关的独立危险因素。结果:单因素分析显示病例组高血糖、败血症、呼吸窘迫综合征(RDS)、寒冷损伤综合征的发生比率显著高于对照组,差异有统计学意义(P<0.05)。经多元logistic回归分析显示,败血症(OR=5.004,P=0.001)、RDS(OR=3.880,P=0.013)、寒冷损伤综合征(OR=3.207,P=0.023)是发生CLS的独立危险因素。结论:败血症、RDS、寒冷损伤综合征是CLS发生的独立危险因素;高血糖可能与CLS的发生有关。
Abstract
OBJECTIVE: To study the risk factors for capillary leak syndrome (CLS) in neonates. METHODS: The clinical data of 52 neonates with CLS (case group) were retrospectively reviewed. Fifty hospitalized neonates without CLS were used as the control group. The possible factors for the development of CLS were identified by univariate analysis. The independent risk factors for CLS were determined by multivariate logistic regression analysis. RESULTS: The univariate analysis showed that the incidences of hyperglycemia, respiratory distress syndrome (RDS), sepsis and cold injury syndrome in the case group were significantly higher than those in the control group (P<0.05). The logistic regression analysis showed that sepsis (OR=5.004, P=0.001), RDS (OR=3.880, P=0.013) and cold injury syndrome (OR=3.207, P=0.023) were the independent risk factors for the development of CLS. CONCLUSIONS: RDS, sepsis and cold injury syndrome are independent risk factors for CLS in neonates. Hyperglycemia may be associated with the development of CLS.
关键词
毛细血管渗漏综合征 /
危险因素 /
新生儿
Key words
Capillary leak syndrome /
Risk factor /
Neonate
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1]Marx G. Fluid therapy in sepsis with capillary leakage[J]. Eur J Anaesthesio1, 2003,20(6):429-442.
[2]Marx G, Vangerow B, Burczyk C, Gratz KF, Maassen N, Cobas Meyer M, et al. Evaluation of noninvasive determinants for capillary leakage syndrome in septic shock patients[J]. Intensive Care Med, 2000, 26(9): 1252-1258.
[3]Druey KM, Greipp PR. Narrative review: the systemic capillary leak syndrome[J]. Ann Intern Med, 2010, 153(2): 90-98.
[4]杨万杰. 毛细血管渗漏综合征临床研究进展[J]. 医学综述,2008,14(24):24-25.
[5]Hamacher J, Lucas R, Lijnen HR, Buschke S, Dunant Y, Wendel A, et al. Tumor necrosis factoralpha and angiostatin are mediators of endothelial cytotoxicity in bronchoalveolar lavages of patients with acute respiratory distress syndrome[J]. Am J Respir Crit Care Med, 2002, 166(5): 651-656.
[6]Speziale G, Ferroni P, Ruvolo G, Fattouch K, Pulcinelli FM, Lenti L, et al. Effect of normothermic versus hypothermic cardiopulmonary bypass on cytokine production and platelet function[J]. J Cardiovasc Surg (Torino), 2000, 41(6):819-827.
[7]刘成军, 刘露, 许峰.小儿先天性心脏病体外循环术后毛细血管渗漏综合征的影响因素[J]. 中国实用儿科杂志, 2006,21(10):753-755.