| 胡湘然,茆宁,孟令建,等.极低出生体质量儿高甘油三酯血症对呼吸结局的影响[J].安徽医药,2026,30(4):732-737. |
| 极低出生体质量儿高甘油三酯血症对呼吸结局的影响 |
| The impact of hypertriglyceridemia on respiratory outcomes in extremely low birth weight infants |
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| DOI：10.3969/j.issn.1009-6469.2026.04.019 |
| 中文关键词: 婴儿，极低出生体质量 高甘油三酯血症 肠外营养 脂质耐受性 呼吸结局 |
| 英文关键词: Infant, very low birth weight Hypertriglyceridemia Parenteral nutrition Lipid tolerance Respiratory outcomes |
| 基金项目:江苏省妇幼健康项目( F201850) |
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| 中文摘要: |
| 目的探讨肠外营养期间发生高甘油三酯血症对极低出生体质量儿呼吸结局的影响。方法回顾性收集 2019年 1月至 2023年 5月入住徐州医科大学附属医院的 199例胎龄 <32周且出生体质量 <1 500 g的早产儿数据。以血清甘油三酯值 1.70 mmol/L为标准，分为高脂血症组和非高脂血症组，分析比较两组一般资料及呼吸方面相关数据，同时根据胎龄进行分层，比较胎龄 <28周、 28~30周、 >30~32周三组早产儿脂质耐受性及高脂血症发生率的差异，并根据主要呼吸结局即是否有创通气 >7 d进行分组，通过结果变量为二值变量的多重 logistic回归评估协变量对有创通气 >7 d的影响。结果高甘油三酯血症总体发生率为 38.5%，分层比较显示胎龄 <28周的早产儿高脂血症发生率明显升高，脂质耐受性降低( P<0.05)。高脂血症组有创通气时间>7 d(56.1%比 36.2%，P<0.05)及支气管肺发育不良发生率(75.8%比 47.6%，P<0.05)明显高于非高脂血症组。高甘油三酯血症、拔管失败及血管活性药物的使用是有创通气时间 >7 d的危险因素［ OR分别为 2.97、11.17、9.51，P=0.013、0.002、<0.001， 95%CI:(1.26，7.02)、(2.51，49.78)、24.41)］。结论极低出生体质量儿机械通气时间延长、(3.71， 支气管肺发育不良的发生可能与高脂血症有关。胎龄越小的早产儿，脂质耐受性越差。 |
| 英文摘要: |
| Objective To explore the impact of hypertriglyceridemia during parenteral nutrition on the respiratory outcomes of ex-tremely low birth weight infants.Methods Data on 199 premature infants with gestational age<32 weeks and birth weight<1500g whowere admitted to Xuzhou Medical University Affiliated Hospital from January 2019 to May 2023 were retrospectively collected. The in-fants were divided into hypertriglyceridemia group and non hypertriglyceridemia group based on a serum triglyceride value of 1.70mmol/L. The differences in respiratory outcomes between the two groups were analyzed and compared. At the same time, the infantswere stratified according to gestational age, the differences in lipid tolerance and incidence of hypertriglyceridemia among three groupsof premature infants with gestational age <28 weeks, 28-30 weeks, and >30-32 weeks were compared. Then all the infants were groupedbased on the primary respiratory outcome of whether they required invasive ventilation for more than 7 days, evaluated the impact of co-variates on invasive ventilation for >7 days through multiple logistic regression with binary outcome variables.Results The overall in-cidence of hypertriglyceridemia was 38.5%, and stratified comparison showed a significant increase in the incidence of hypertriglyceri-demia and a decrease in lipid tolerance in premature infants with gestational age <28 weeks (P<0.05). The incidence of invasive ventila-tion time >7 days (56.1% vs. 36.2%, P<0.05) and bronchopulmonary dysplasia (75.8% vs. 47.6%, P<0.05) in the hyperlipidemia group were significantly higher than those in the non hyperlipidemia group. Hypertriglyceridemia, re-intubation, and use of vasoactive drugs were risk factors for invasive ventilation time >7 days [OR=2.97, 11.17, 9.51; P=0.013, 0.002, <0.001; 95%CI: (1.26, 7.02), (2.51, 49.78), (3.71, 24.41)].Conclusion The prolonged mechanical ventilation time and the occurrence of bronchopulmonary dysplasia inextremely low birth weight infants may be related to hypertriglyceridemia. Premature infants with younger gestational age have poorerlipid tolerance. |
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