| 摘要: |
| 目的:系统评价超/ 极早产儿(EPT/ VPT)和超/ 极低出生体质量(ELBW/ VLBW) 新生儿急性肾损伤(AKI) 危险因素及关
联强度。方法:检索中国知网、维普、万方、中国生物医学文献数据库、PubMed、EMBase、the Cochrane Library 数据库截至2025 年
2 月28 日关于EPT/ VPT 和ELBW/ VLBW 新生儿AKI 危险因素的临床研究,按纳入标准及排除标准进行文献筛选、数据提取和
质量评价,应用RevMan 5. 3 软件进行Meta 分析。结果:共纳入14 篇文献,包括3 034 例患儿。结果显示,胎龄小( OR= 1. 38,
95%CI 1. 20~1. 59,P<0. 01)、5 min Apgar 评分低(OR= 4. 79,95%CI 1. 95~11. 75,P<0. 01)、败血症( OR= 3. 54,95%CI 2. 74~
4. 58,P<0. 01)、机械通气(OR=3. 60,95%CI 2. 70~4. 80,P<0. 01)、非甾体抗炎药(OR= 2. 67,95%CI 1. 68~4. 24,P<0. 01)、万
古霉素(OR=2. 61,95%CI 1. 54~4. 43,P<0. 01)、血管活性药物( OR = 4. 06,95%CI 2. 92 ~ 5. 66,P<0. 01)、呼吸窘迫综合征
(OR=3. 51,95%CI 2. 46~4. 99,P<0. 01)、动脉导管未闭( OR= 2. 43,95%CI 1. 92~3. 06,P<0. 01) 和脑室出血( IVH) ≥3 级
(OR=3. 19,95%CI 1. 87~5. 45,P<0. 01)是EPT/ VPT 和ELBW/ VLBW 新生儿发生AKI 的危险因素。结论:应重点关注以上
EPT/ VPT 和ELBW/ VLBW 新生儿AKI 危险因素及关联强度,做到早期预防、早期识别和早期治疗,降低AKI 发生率及严重
程度。 |
| 关键词: 超/ 极早产儿 超/ 极低出生体质量新生儿 急性肾损伤 危险因素 Meta 分析 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2025.12.004 |
|
| 基金项目: |
|
| Systematic Review of Risk Factors for Acute Kidney Injury in Neonates with Extremely Preterm / VeryPreterm and Very Low Birth Weight / Extremely Low Birth Weight |
| Han Luyan, Sun Ning, Liu Jing, Liu Wenxin, Shi Xiaoxia |
| (Hengshui Maternal and Child Health Hospital, Hebei Hengshui
053000, China) |
| Abstract: |
| Objective: To systematically evaluate the risk factors for acute kidney injury (AKI) in neonates with extremely preterm/ very
preterm (EPT/ VPT) and very low birth weight/ extremely low birth weight (VLBW/ ELBW). Methods: CNKI, VIP, Wanfang,
SinoMed, PubMed, EMBase and the Cochrane Library were retrieved to collect Clinical studies related to risk factors for AKI in
newborns with EPT/ VPT and VLBW/ ELBW from database establishment to Feb. 28th , 2025. Literature screening, data extraction and
quality evaluation were performed according to the inclusion and exclusion criteria. Meta-analysis was performed by using RevMan 5. 3
software. Results: A total of 14 studies and 3,034 patients were included. Meta-analysis showed that small gestational age (OR=1. 38,2. 74 to 4. 58, P<0. 01), mechanical ventilation (OR=3. 60, 95%CI 2. 70 to 4. 80, P<0. 01), non-steroidal anti-inflammatory drugs
(OR=2. 67, 95%CI 1. 68 to 4. 24, P<0. 01), vancomycin (OR = 2. 61, 95%CI 1. 54 to 4. 43, P<0. 01), vasoactive drugs (OR =
4. 06, 95%CI 2. 92 to 5. 66, P<0. 01), respiratory distress syndrome (OR = 3. 51, 95%CI 2. 46 to 4. 99, P<0. 01), patent ductus
arteriosus (OR=2. 43, 95%CI 1. 92 to 3. 06, P<0. 01), and intraventricular hemorrhage (IVH) ⩾ grade 3 (OR=3. 19, 95%CI 1. 87
to 5. 45, P<0. 01) were risk factors for AKI in neonates with EPT/ VPT and ELBW/ VLBW. Conclusion: Attention should be payed on
the risk factors and the association strength for AKI in neonates with EPT/ VPT and ELBW/ VLBW. Early detection, prevention and
treatment should be carried out to reduce the incidence and severity of AKI. |
| Key words: extremely preterm/ very preterm infants neonates with very low birth weight/ extremely low birth weight acute kidney
injury risk factors Meta-analysis |
