| Chapter ? Risk predicttion analysis of bronchopulmonary dysplasia under the new diagnostic criteriaObjective:To explore the risk factors of bronchopulmonary dysplasia under the new diagnostic criteria,to look for the possible factors for early prediction of BPD and to establish a prediction model.Methods:Premature infants with gestational age<32 weeks admitted to our neonatology department from August 2015 to August 2018 were selected.General clinical data,related complications,oxygen therapy,drugs and laboratory results were collected.It was divided into BPD group and non-BPD group according to the 2001 diagnostic criteria and 2018 diagnostic criteria respectively,and the incidence of BPD under the two diagnostic criteria was compared.Under the 2018 diagnostic criteria,SPSS statistical software was used to analyze the clinical characteristics of BPD group and non-BPD group.The R software and Lasso method were used to screen out the risk factors for early prediction of BPD and establish the risk prediction model.The differentiation and calibration of the model were evaluated.Results:The incidence of BPD under 2001 diagnostic criteria was 44.9%,significantly higher than that under 2018 diagnostic criteria(11.2%)(P<0.05).Mortality in BPD group was significantly higher than that in non-BPD group under 2018 diagnostic criteria(P<0.05).There was no significant difference in mortality between BPD group and non-BPD group under 2001 diagnostic criteria(P>0.05).Fourteen possible variables were selected by Lasso method,the penalty coefficient ?=0.0154.The factors that eventually entered the Logistic regression model were:birth weight(OR=0.9945,95%CI:0.9904?0.9979),resuscitation way(OR=4.8249,95%CI:1.3990?19.4752),intrauterine distress(OR=8.0586,95%CI:1.7810?39.5696),Score for Neonatal Acute Physiology-? and Perinatal Extension(OR=1.0880,95%CI:1.0210?1.1639),hematokrit(OR=1.1554,95%CI:1.3990?19.4752)and apnea(OR=7.6916,95%CI:1.4180?52.1236).The C-index after adjusting the fitting deviation is 0.894.Conclusion:This study makes a preliminary exploration of the risk model for early prediction of BPD.The model has good discrimination and calibration.Chapter 2 Retrospective study on early use of aminophylline to prevent bronchopulmonary dysplasiaObjective:To explore whether early use of aminophylline can effectively prevent bronchopulmonary dysplasia in premature infants.Methods:Premature infants with gestational age<32 weeks admitted to the Neonatology Department ffrom August 2015 to August 2018 were selected.General clinical data and early use of preventative drugs were collected.The neonates were divided into aminophylline group,caffeine group and control group according.The incidence of BPD at different gestational ages was compared among the three groups.Results:"GA<28":The incidence of BPD in the aminophylline group was significantly lower than that in the control group,and the duration of mechanical ventilation in the aminophylline and caffeine groups was significantly lower than that in the control group(P<0.05)."28?GA<30":There was no significantly difference in the incidence of BPD among the three groups(P>0.05).But the time under non-invasive ventilation and the total time under oxygen in the aminophylline group was significantly lower than that in the caffeine group(P<0.05)."30?GA<32":There was no difference in the incidence of BPD among the three groups(P>0.05).But the time under non-invasive ventilation and the total time under oxygen in the aminophylline group was significantly lower than that in the control group(P<0.05).Conclusion:Early prophylactic use of aminophylline in preterm with GA<28 weeks can reduce the incidence of BPD and reduce the time under mechanical ventilation.The prophylactic use of aminophylline in preterm with GA?28 weeks can reduce the time under non-invasive ventilation and the total time under oxygen..Blood drug concentration should be monitored to avoid side effects caused by drug poisoning when using aminophylline. |
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