双胎早产儿支气管肺发育不良危险因素分析：一项多中心研究

doi:10.7499/j.issn.1008-8830.2312005

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摘要目的分析胎龄<34周双胎早产儿发生支气管肺发育不良（bronchopulmonary dysplasia, BPD）的危险因素，为临床早期识别双胎早产儿BPD的发生提供依据。方法回顾性收集全国22家医院2018年1月—2020年12月收治的胎龄<34周双胎早产儿，根据双胎儿患病情况分为三组：两胎均为BPD组、仅一胎为BPD组、两胎均非BPD组，分析双胎早产儿发生BPD的危险因素；并对仅一胎为BPD组患儿进一步分析，组内配对分析双胎早产儿发生BPD的产后危险因素。结果共纳入胎龄<34周的双胎儿共904对。多因素logistic回归分析中，与两胎均非BPD组相比，双胎出生体重差异>25%是双胎中仅一胎患BPD的危险因素（OR=3.370，95%CI：1.500~7.568，P<0.05），胎龄大是双胎均患BPD的保护因素（P<0.05）。对双胎中仅一胎为BPD组进行组内条件logistic回归分析，提示小于胎龄儿是双胎内个体发生BPD的危险因素（OR=5.017，95%CI：1.040~24.190，P<0.05）。结论双胎早产儿BPD的发生不仅与胎龄相关，也与双胎出生体重差异、小于胎龄儿密切相关。

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	樊雨薇
	张伊佳
	温和梅
	晏红
	沈蔚
	丁月琴
	龙运峰
	张志钢
	李桂芳
	姜泓
	饶红萍
	邱建武
	魏贤
	张亚昱
	曾纪斌
	赵常亮
	许伟鹏
	王凡
	员丽
	杨秀芳
	李薇
	林霓阳
	陈倩
	夏昌顺
	钟鑫琪
	崔其亮

关键词 ：支气管肺发育不良, 危险因素, 多中心研究, 双胎儿, 早产儿

Abstract：Objective To investigate the risk factors for bronchopulmonary dysplasia (BPD) in twin preterm infants with a gestational age of <34 weeks, and to provide a basis for early identification of BPD in twin preterm infants in clinical practice. Methods A retrospective analysis was performed for the twin preterm infants with a gestational age of <34 weeks who were admitted to 22 hospitals nationwide from January 2018 to December 2020. According to their conditions, they were divided into group A (both twins had BPD), group B (only one twin had BPD), and group C (neither twin had BPD). The risk factors for BPD in twin preterm infants were analyzed. Further analysis was conducted on group B to investigate the postnatal risk factors for BPD within twins. Results A total of 904 pairs of twins with a gestational age of <34 weeks were included in this study. The multivariate logistic regression analysis showed that compared with group C, birth weight discordance of >25% between the twins was an independent risk factor for BPD in one of the twins (OR=3.370, 95%CI: 1.500-7.568, P<0.05), and high gestational age at birth was a protective factor against BPD (P<0.05). The conditional logistic regression analysis of group B showed that small-for-gestational-age (SGA) birth was an independent risk factor for BPD in individual twins (OR=5.017, 95%CI: 1.040-24.190, P<0.05). Conclusions The development of BPD in twin preterm infants is associated with gestational age, birth weight discordance between the twins, and SGA birth.

Key words： Bronchopulmonary dysplasia Risk factor Multicenter study Twins Preterm infant

收稿日期: 2023-12-04

基金资助:广州市科技计划项目（2023A03J0382）。

通讯作者: 崔其亮，男，主任医师，Email：cuiql_gysy@163.com E-mail: cuiql_gysy@163.com

作者简介: 樊雨薇，女，硕士研究生；

引用本文:

樊雨薇,张伊佳,温和梅等. 双胎早产儿支气管肺发育不良危险因素分析：一项多中心研究[J]. 中国当代儿科杂志, 2024, 26(6): 611-618.

FAN Yu-Wei,ZHANG Yi-Jia,WEN He-Mei et al. Risk factors for bronchopulmonary dysplasia in twin preterm infants: a multicenter study[J]. CJCP, 2024, 26(6): 611-618.

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http://www.zgddek.com/CN/10.7499/j.issn.1008-8830.2312005 或 http://www.zgddek.com/CN/Y2024/V26/I6/611

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