CAJ | 학술논문

目的：探讨晚期早产儿高胆红素血症的危险因素。方法回顾性分析2011年至2012年收治的211例高胆红素血症晚期早产儿和246例非高胆红素血症晚期早产儿的临床资料，分析可能造成晚期早产儿高胆红素血症的危险因素。结果211例高胆红素晚期早产儿中27例为重症，晚期早产儿高胆红素血症发生与新生儿相关的因素包括：入院时日龄<3d、出生窒息、小于胎龄儿、头颅血肿或明显产伤淤血、低白蛋白血症、红细胞增多症、感染、溶血病、喂养不耐受、胎粪排泄延迟10个变量；与母亲相关的因素包括：来自农村、妊娠高血压综合征（妊高症）及胎膜早破3个变量。以上变量在高胆红素血症和非高胆红素血症晚期早产儿中的差异均有统计学意义（P<0.05）。多因素Logistic回归分析显示，出生窒息、胎粪排泄延迟、低白蛋白血症和母亲妊高症为晚期早产儿高胆红素血症的危险因素（OR=2.35~4.05）；母亲妊高症和新生儿溶血病是晚期早产儿发生重度高胆红素血症的危险因素（OR=5.74、73.64）。结论出生窒息、胎粪排泄延迟、低白蛋白血症、溶血病及母亲妊高症是晚期早产儿高胆红素血症发生的高危因素。加强妊高症和新生儿溶血病诊治，可减少晚期早产儿重度高胆红素血症的发生。
목적：탐토만기조산인고담홍소혈증적위험인소。방법회고성분석2011년지2012년수치적211례고담홍소혈증만기조산인화246례비고담홍소혈증만기조산인적림상자료，분석가능조성만기조산인고담홍소혈증적위험인소。결과211례고담홍소만기조산인중27례위중증，만기조산인고담홍소혈증발생여신생인상관적인소포괄：입원시일령<3d、출생질식、소우태령인、두로혈종혹명현산상어혈、저백단백혈증、홍세포증다증、감염、용혈병、위양불내수、태분배설연지10개변량；여모친상관적인소포괄：래자농촌、임신고혈압종합정（임고증）급태막조파3개변량。이상변량재고담홍소혈증화비고담홍소혈증만기조산인중적차이균유통계학의의（P<0.05）。다인소Logistic회귀분석현시，출생질식、태분배설연지、저백단백혈증화모친임고증위만기조산인고담홍소혈증적위험인소（OR=2.35~4.05）；모친임고증화신생인용혈병시만기조산인발생중도고담홍소혈증적위험인소（OR=5.74、73.64）。결론출생질식、태분배설연지、저백단백혈증、용혈병급모친임고증시만기조산인고담홍소혈증발생적고위인소。가강임고증화신생인용혈병진치，가감소만기조산인중도고담홍소혈증적발생。
Objective To explore the risk factors of hyperbilirubinemia in late preterm infants. Methods Clinical data of 211 cases of late preterm infants with hyperbilirubinemia and 246 cases of late preterm infants without hyperbilirubinemia were retro-spectively analyzed between 2011 and 2012. The risk factors of hyperbilirubinemia were filtered. Results Twenty-seven cases of late premature infants with hyperbilirubinemia were severe. Hospital stay less than 3 days, birth asphyxia history, small for gestatio-nal age, head hematoma, delivery injury, hypoalbuminemia, polycythemia, infection, hemolytic disease, feeding intolerance, and fe-tal excretion delay were associated with hyperbilirubinemia (P<0.05). Rural origin, pregnancy-induced hypertension syndrome and premature rupture of membrane were also associated with hyperbilirubinemia (P<0.05). Multivariate logistic regression analysis showed the history of birth asphyxia , fetal excretion delay, hypoalbuminemia, pregnancy-induced hypertension syndrome were risk factors of hyperbilirubinemia in late preterm infants (OR=2.35-4.05). Pregnancy-induced hypertension syndrome and hemolytic dis-ease were risk factors of severe hyperbilirubinemia in late preterm infants (OR=5.74, 73.64). Conclusions Neonatal asphyxia, fetal excretion delay, hypoalbuminemia and pregnancy-induced hypertension syndrome are risk factors of hyperbilirubinemia in late pre-term infants. Strengthening the management of pregnancy-induced hypertension syndrome and the treatment of newborn hemolytic disease can reduce the occurrence of severe hyperbilirubinemia in late preterm infants.