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目的支气管肺发育不良(BPD)发病因素复杂,本文以多因素分析法分析其独立危险因素,并分析因素间的交互作用,为该病防治提供依据。方法采用病例对照研究对BPD 36种危险因素进行调查,对单因素分析中有显著性意义的因素进行非条件logistic回归分析,并以加法模型理论分析因素间的交互作用。结果单因素分析显示男婴、胎龄≤32周、出生体重≤1500 g、胎膜早破、产道感染、孕母产前羊膜炎、PDA、反复肺部感染、机械通气>10 d、碳青霉烯类抗生素>4周等10个危险因素差异有统计学意义(P<0.05);非条件logistic回归分析显示胎龄≤32周(OR=7.8394)、胎膜早破(OR=2.9313)、孕母产前羊膜炎(OR=7.7790)、反复感染性肺炎(OR=7.8120)、碳青霉烯类抗生素>4周(OR=7.4699)为BPD的独立危险因素;交互分析显示,胎龄≤32周与机械通气>10 d、胎龄≤32周与出生体重≤1500 g、胎龄≤32周与反复肺部感染、出生体重≤1500 g与反复肺部感染(X19)等之间存在正交互作用(交互指数大于1)。结论该病的发生与多种独立危险因素有关,多个危险因素并存亦加大了该病发生的可能性,临床上应加强对相关危险因素的监测和处理。
Objective To study the complicated pathogenesis of bronchopulmonary dysplasia (BPD). In this paper, multivariate analysis was used to analyze the independent risk factors and to analyze the interaction between factors so as to provide evidence for the prevention and treatment of this disease. Methods A case-control study was conducted to investigate 36 risk factors of BPD. Non-conditional logistic regression analysis was used to analyze the significant factors in the univariate analysis, and the interaction between the factors was analyzed with additive model theory. Results Univariate analysis showed that the male infants with gestational age ≤ 32 weeks, birth weight ≤ 1500 g, premature rupture of membranes, birth canal infection, prenatal amniotic placenta, PDA, recurrent pulmonary infection, mechanical ventilation> 10 days, (P <0.05). The unconditional logistic regression analysis showed that gestational age≤32 weeks (OR = 7.8394), premature rupture of membranes (OR = 2.9313) (OR = 7.8120), carbapenem antibiotics> 4 weeks (OR = 7.4699) were independent risk factors of BPD. The interaction analysis showed that gestational age≤ 32 weeks and mechanical ventilation> 10 d, gestational age ≤ 32 weeks and birth weight ≤ 1500 g, gestational age ≤ 32 weeks and recurrent lung infections, birth weight ≤ 1500 g and recurrent lung infections (X19) exist between positive Interaction (interaction index greater than 1). Conclusions The occurrence of the disease is related to a number of independent risk factors. The coexistence of multiple risk factors also increases the possibility of the disease. Clinically, we should strengthen the monitoring and management of related risk factors.