在早产婴儿多发性败血症和/或死角性肠球炎后的不良神经发育:重新审视单一事件范式
Jae Hui Ryu1, Seung Han Shin2, Baek Sup Shin3
1Department of Pediatrics, Ewha Womans University College of Medicine, Ewha Womans University Mokdong Hospital, Seoul, South Korea.
Pediatric research
|June 7, 2025
概括
多发性败血症和/或死性肠球炎 (NEC) 显著增加了早产婴儿的神经发育障碍 (NDI) 的风险. 单一的败血症情节本身并没有提高NDI风险,这突显了跟踪炎症事件频率的重要性.
科学领域:
- 新生儿医学 新生儿医学
- 发育儿科 发育儿科
- 传染病流行病学 传染病流行病学
背景情况:
- 早产婴儿的全身炎症与神经发育不良结果有关.
- 调查单个和多个炎症事件的差异影响至关重要.
研究的目的:
- 为了确定单次或多次败血症和/或死性肠球炎 (NEC) 和神经发育障碍 (NDI) 在非常低出生体重 (VLBW) 的早产婴儿之间的关联.
- 为了区分神经发育风险,由系统性炎症的不同频率所造成的.
主要方法:
- 全国范围的VLBW婴儿队列研究 (怀孕32周以下出生,2013-2020年).
- 婴儿根据败血症和/或NEC发生情况进行分类.
- 神经发育评估是在18-24个月的年龄进行的,NDI或死亡是主要结果.
主要成果:
- 多次败血症发作 (aOR=1.43) 或联合败血症和NEC (aOR=1.91) 显著增加了NDI风险.
- 没有NEC的单次败血症发作与增加的NDI风险没有显著关联.
- 复发性炎症发作显示了对神经发育结果的剂量依赖性影响.
结论:
- 多次败血症和/或NEC是VLBW婴儿NDI的重要风险因素.
- 一个单一的败血症,孤立地,似乎不会提高NDI的风险.
- 对早产婴儿神经发育结果的临床评估应考虑系统性炎症的累积负担.
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