| 高旭,刘会领,王昕,等.生后 24 h内白蛋白对超低出生体重儿支气管肺发育不良的预测价值[J].安徽医药,2025,29(6):1218-1222. |
| 生后 24 h内白蛋白对超低出生体重儿支气管肺发育不良的预测价值 |
| The predictive value of albumin within the first 24 hours after birth for bronchopulmonary dysplasia in extremely low birth weight infants |
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| DOI：10.3969/j.issn.1009-6469.2025.06.031 |
| 中文关键词: 支气管肺发育不良 白蛋白类 超低出生体重儿 早产儿 住院时间 |
| 英文关键词: Bronchopulmonary dysplasia Albumins Extremely low birth weight infants Premature Length of hospital stay |
| 基金项目:沧州市科技计划自筹经费项目( 23244102021) |
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| 中文摘要: |
| 目的探讨生后 24 h内白蛋白对超低出生体重( ELBW)儿支气管肺发育不良( BPD)的预测价值。方法回顾性分析 2019年 11月至 2023年 6月沧州市人民医院收治的在出生后 1h内即转入新生儿重症监护病房( NICU)的体质量低于 1 000 g、胎龄小于 32周、出院时校正胎龄 >36周的 ELBW儿的临床资料。根据入组 ELBW儿是否患 BPD分为 BPD组与非 BPD组。收集整理纳入研究的 ELBW儿的一般临床资料及生后 24 h内白蛋白数据。结果共纳入 62例 ELBW儿，其中 BPD组 24例(38.7%)非 BPD组 38例( 61.3%)。两组在胎龄、机械通气时间、住院时间、妊娠期高血压比例、早产儿视网膜病变发生率等指标上差统计学意义( P<0.05)。 BPD组病儿生后 24 h内白蛋白低于非 BPD组［( 29.86±3.68)g/L比( 26.95±2.36)g/L，P<异有，0.05］。两组生后 24 h内的球蛋白、前白蛋白、总蛋白等指标比较，差异无统计学意义( P>0.05)。多因素 logistic回归分析结果表明，生后 24 h内白蛋白［ OR=0.70，95%CI:(0.54，0.90)］、住院时间［ OR=1.07，95%CI:(1.02，1.12)］是 ELBW儿发生 BPD的独立危险因素(P<0.05)。受试者操作特征曲线(ROC曲线)分析显示生后 24 h内白蛋白的最佳截断值为 27.40 g/L，曲线下面积为0.76，灵敏度为71.43%，特异度为 77.42%，约登指数为 0.49；住院时间的最佳截断值为 83.00 d，曲线下面积为 0.75，灵敏度为58.33%，特异度为 86.84%，约登指数为 0.45。结论生后 24 h内较低的白蛋白、较长的住院时间是 ELBW儿发生 BPD的独立危险因素，生后 24 h内较低的白蛋白对 ELBW儿 BPD具有良好的预测价值。 |
| 英文摘要: |
| Objective To investigate the predictive value of albumin within the first 24 hours after birth on bronchopulmonary dyspla-sia (BPD) in extremely low birth weight (ELBW) infants.Methods The clinical data of ELBW infants, who, from November 2019 toJune 2023, were transferred to the neonatal intensive care unit (NICU) in Cangzhou People's Hospital within 1 hour after birth, with abody weight lower than 1 000 g, gestational age younger than 32 weeks and corrected gestational age older than 36 weeks at discharge,were retrospectively analyzed. According to whether ELBW infants suffered from BPD or not, they were assigned into BPD group andnon-BPD group. The general clinical data and albumin levels within the first 24 hours after birth of the extremely low birth weight in-fants included in the study were collected.Results A total of 62 ELBW infants were included in this study. Among them, there were24 (38.7%) cases in the BPD group and 38 (61.3%) cases in the non-BPD group. There were significant differences in gestational age,duration of mechanical ventilation, length of hospital stay, proportion of maternal hypertension during pregnancy, and incidence of reti-nopathy of prematurity (ROP) between the two groups (P<0.05). The albumin level in the BPD group was significantly lower than that in the non-BPD group within the first 24 hours after birth [(29.86±3.68) g/L vs. (26.95±2.36) g/L, P<0.05]. There were no significant differ-ences between the two groups in levels of globulin, prealbumin, and total protein at 24 h (P>0.05). The results of multivariate logistic re-gression analysis showed that albumin [OR=0.70, 95%CI: (0.54, 0.90)] and length of hospital stay [OR=1.07, 95%CI: (1.02,1.12)] with-in the first 24 hours after birth were independent risk factors for BPD in ELBW infants (P<0.05). Receiver operating characteristic (ROC) curve analysis results showed that the optimal cut-off value of albumin was 27.40 g/L, the area under the curve was 0.76, the sen-sitivity was 71.43%, the specificity was 77.42%, and the Youden index was 0.49; the optimal cut-off value of the length of hospital staywas 83.00 days, the area under the curve 0.75, the sensitivity 58.33%, the specificity 86.84%, and the Youden index 0.45. Conclu. sion Lower albumin level and longer hospital stay within the first 24 hours after birth are independent risk factors for BPD in ELBW infants, and lower albumin level within the first 24 hours after birth has a good predictive value for BPD in ELBW infants. |
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