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发育医学电子杂志  2022, Vol. 10 Issue (4): 283-289    DOI: 10.3969/j.issn.2095-5340.2022.04.006
  围产医学   论著 |新生儿 |
超早产儿与超低出生体质量儿支气管肺发育不良的性别差异
苏志文 林黎黎 黄小霞 吴璜 魏坚伟 贾春宏 吴繁 崔其亮
广州医科大学附属第三医院 儿科,广东 广州 510150
Gender difference in broncho-pulmonary dysplasia for extremely preterm infant andextremely low birth weight infant
Su Zhiwen, Lin lili, Huang Xiaoxia, et al
(Departmentof Pediatrics, the Third Affiliated Hospital of Guangzhou Medical University, Guangdong, Guangzhou510150, China)
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摘要 【摘要】 目的  探讨性别是否为超早产儿(extremely preterm infant,EPI)与超低出生体质量儿(extremely lowbirth weight infant,ELBWI)发生支气管肺发育不良(broncho-pulmonary dysplasia,BPD)的影响因素。方法 采用回顾性研究方法对2010 年1 月1 日至2019 年12 月31 日在广州医科大学附属第三医院新生儿科收治的胎龄<28 周和出生体质量<1 000 g、且存活≥ 28 d 的380 例EPI 与ELBWI 的临床资料进行分析,研究性别对BPD 发生率的影响,并从出生年份、出生胎龄和体质量等方面比较不同性别
患儿发生BPD 的差异。统计学方法用秩和检验、χ2 检验、χ2 趋势检验、校正χ2 检验或Fisher 确切概率
法。 结果 男性EPI 与ELBWI 的BPD 发生率显著高于女性[87.9%(174/198)与68.7%(125/182),
χ2=20.838,P<0.001]。男女患儿的BPD 发生率均呈逐年上升趋势(χ2 趋势值分别为12.721 和27.153,
P 值均<0.001)。2010 至2014 年和2015 至2019 年,男性EPI 与ELBWI 的BPD 发生率均高于女性
[79.2%(57/72)与41.1%(23/56),92.9% (117/126)与 81.0%(102/126)],差异均具有统计学意义(χ2 分别为19.505,7.846,P 值均<0.01);与2010 至2014 年相比较,2015 至2019 年男性和女性EPI 与ELBWI的BPD 发生率均明显增加(P 值均<0.05),但女性的发生率增加幅度更[81.0%(102/126)与 41.1%(23/56),χ2=28.667,P<0.01], 各组按不同出生胎龄分为<26 周组、26~26+6 周组和27~27+6 周组,男性和女性EPI 与ELBWI 的BPD 发生率比较,差异均无统计学意义(P>0.05);出生胎龄 28~28+6 周组和29~29+6 周组的ELBWI,男性和女性BPD 的发生率比较[96.3%(26/27)与92.8%(23/25),73.7%(28/38)与52.0%(13/25),P 值分别为0.039, 0.005],差异均有统计学意义。按不同出生体质量分组,在ELBWI非EPI 的患儿中,出生体质量<800 g 组和800~899 g 组的男性和女性BPD 的发生率比较,差异无统计学意义(P值均>0.05);而出生体质量 900~999 g 组中男性患儿的BPD发生率高于女性患儿[73.2%(41/56)与48.3%(29/60)],差异均具有统计学意义(P 值均<0.05)。  结论 男性EPI/ELBWI 是BPD 的易感对象,出生胎龄28~29 周的男性ELBWI 的BPD“易患性”更为突出。
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关键词:  性别差异  超早产儿  超低出生体质量儿  支气管肺发育不良    
Abstract: 【Abstract】 Objective To study whether the gender was the influential factor of the occurrence of
broncho-pulmonary dysplasia in extremely preterm infatns (EPI) and extremely low birth weight infatns
(ELBWI). Method From January 1, 2010 to December 31, 2019, 380 cases of EPI and ELBWI with
gestational age <28 weeks , birth weight <1 000 g, and survival ≥28 days , their clinical data was analyzedby retrospective method , who were treated in the Departmant of Neonatology, the Third Affiliated Hospitalof Guangzhou Medical University. To study the influence of gender on the incidence of BPD, and tocompare the differences in the incidence of BPD among infants of different genders in terms of the year ofbirth, different gestational age and birth weight. Statistical methods performed by Rank-sum test, χ2 test, χ2trend test, corrected χ2 test or Fisher's exact probability method. Result The incidence of BPD in maleswith EPI and ELBWI was significantly higher than that in females [87.9% (174/198) vs 68.7% (125/182),χ2=20.838, P<0.001).The incidence of BPD in both males and female children was increasing year by year(χ2 value trend was 12.721, 27.153, all P<0.001). In the first 5 years (2010-2014) and the last 5 years (2015-2019), the incidence of BPD in males with EPI and ELBWI was higher than that in females [79.2% (57/72)vs 41.1%(23/56), 92.9% (117/126) vs 81.0% (102/126), χ2=19.505, 7.846, all P<0.01], which was statisticalsignificance. Compared with the previous 5 years, the incidence of BPD in both male and female EPI andELBWI was significantly increased in the latter 5 years (χ2=8.062, 28.667, all P<0.01), but the increase ofincidence in female was even greater [81.0% (102/126) vs 41.1% (23/56), χ2=28.667, P<0.01]. According todifferent gestational age, there were all no significant differences in the incidence of BPD between male andfemale EPI/ELBWI in the groups of <26 weeks, 26-26+6 weeks and 27-27+6 weeks (all P>0.05). In the groupof gestational age with 28-28+6 week and 29-29+6 week , there were both significant differences between maleand female in ELBWI [96.3% (26/27) vs 92.8% (23/25), 73.7% (28/38) vs 52.0% (13/25), P=0.039, 0.005].Grouped by different birth weight, among the infants with ELBWI and non-EPI, there was no statisticallysignificant difference in the incidence of BPD between male and female in the birth weight <800 g and 800-899 g groups (all P>0.05), but the incidence of BPD in male infants was higher than that in female infantsin 900-999 g birth weight group [73.2% (41/56) vs 48.3% (29/60), all P<0.05]. Conclusion Male EPI/ELBWI is the predisposing target of BPD, and the "susceptibility" of BPD in male ELBWI of gestational age28-29 weeks is more prominent.
Key words:  Gender difference    Extremely preterm infant    Extremely low birth weight infant    Bronchopulmonary dysplasia
收稿日期:  2021-12-27                     发布日期:  2022-07-29     
基金资助: 广东省自然科学基金面上项目(2021A1515011225);广东省医学科学技术研究基金项目(A2019069);
广东省科技计划项目(2017ZC0252)
通讯作者:  林黎黎    E-mail:  lilylin7@163.com
引用本文:    
苏志文 林黎黎 黄小霞 吴璜 魏坚伟 贾春宏 吴繁 崔其亮. 超早产儿与超低出生体质量儿支气管肺发育不良的性别差异[J]. 发育医学电子杂志, 2022, 10(4): 283-289.
Su Zhiwen, Lin lili, Huang Xiaoxia, et al. Gender difference in broncho-pulmonary dysplasia for extremely preterm infant andextremely low birth weight infant. Journal of Developmental Medicine(Electronic Version), 2022, 10(4): 283-289.
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