Objective To investigate the risk factors for the incidence of periventricular leukomalacia in Chinese premature infants and provide evidence for decision-making in prevention and treatment of periventricular leukomalacia.Methods The results about the risk factors of periventricular leukomalacia in 14 papers were analyzed by Metaanalysis method. The cumulative cases and controls were 748 and 3 366, respectively. The calculation methods of the merged odds ratio ( OR ) and 95％ confidence interval ( CI) were determined according to the homogeneity test.Results The pooled OR values and 95％ CI were as follows, antenatal steroids 0.46 ( 0.34 ～ 0.61 ), premature rupture of membranes 3.60 ( 1.40 ～ 9.24 ); gestational age 5.05 ( 2.66 ～ 9.58 ); low birth weight 2.78 ( 2.30 ～ 3.35 );severe asphyxia 5.35 ( 2.09 ～ 13.68 ); infection 4.46 ( 3.08 ～ 6.44); mechanical ventilation 3.67 ( 1.74 ～ 7.72 );hypocapnia 4.49 ( 2.03 ～ 9.94); intraventricular hemorrhage 2.00 ( 1.15 ～ 3.45); acidosis 1.58 ( 1.19 ～ 2.08 ).Conclusions The main risk factors for periventricular leukomalacia in China are premature rupture of membranes,gestational age, low birth weight, severe asphyxia, infection, mechanical ventilation, hypocapnia, intraventricular hemorrhage, and acidosis. Antenatal steroids may be a protective factor for periventrictlar leukomalacia.%目的 探讨中国人群早产儿发生脑室周围白质软化的主要危险因素,为今后防治工作提供依据.方法 利用meta分析方法分析国内14篇关于早产儿脑室周围白质软化危险因素的研究文献.累计病例748例,对照3 366例.根据齐性检验结果选择计算各危险因素合并比值比(OR)及其95%可信区间(95%CI)模型.结果 脑室周围白质软化发生的OR值(95%CI)分别为:产前使用激素0.46(0.34～0.61),胎膜早破3.60(1.40～9.24),胎龄5.05(2.66～9.58),低出生体质量2.78(2.30～3.35),重度窒息5.35(2.09～13.68),感染4.46(3.08～6.44),机械通气3.67(1.74～7.72),低碳酸血症4.49(2.03～9.94),脑室内出血2.00(1.15～3.45),酸中毒1.58(1.19～2.08).结论 胎膜早破、胎龄、低出生体质量、重度窒息、感染、机械通气、低碳酸血症、脑室内出血和酸中毒是中国人群早产儿脑室周围白质软化发病的主要危险因素,产前使用激素可能为脑室周围白质软化的保护因素.
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