The Study On Risk Factors For Persistent Pulmonary Hypertension Of Newborn

persistent pulmonary hypertension of newborn (PPHN), Which is a clinical syndrome, characterized by various pathogeny secondary to maintain elevated pulmonary vascular resistance after birth with resultant shunting of pulmonary blood flow to the systemic circulation by across patent foramen oval(PFO) and/or patent ductus arteriosus(PDA). With the progress of science and technology recent year, the study of PPHN has revolutionized development on the diagnose and treatment, we also have made diagnose criteria of clinical and echocardiographic on PPHN, but the mortality and complication is still on higher level, especially in the grass-roots hospital, for lacking of enough acknowledge about it and the reliable diagnose method: echocardiographic Doppler(ECHO), the disease has always been delayed. Aim at this situation, we expect to set up the earlier discriminant method of it. and apply in the grass-roots hospital, or as the early diagnose method of disease.intent to catch hold of rescue time, improve the quality of medical treatment, decline the mortality and handicapped child, which has significance for clinical. MethodsThe research date was obtained from newborn ward in our hospital from August 2001 to October 2002(there were 143 infant.), when patient enrolled, the Arterial blood gas analysis was taken firstly, if premature newborn was PaO:<50mmHg or mature newborn PaOz <65mmHg, then they had ECHO, according to the diagnose criteria of clinical and ECHO, we classified them into two groups: PPHN(40) and non-PPHN(103). recorded all of the relation date. By using statistic software SPSS 10.0, we firstly analysed the link of the single fact of two group and than synthesis all of the facts which relate to the PPHN. Results1. 40 infants were PPHN(143 case of date), 103 were non-PPHN. After analyzed by statistical software SPSS 10.0, those the degree of cyanose and improvement of PaOz /SO (after inhaling high oxygen concentrations) and heart failure and pulmonary disease and pregnancy term and PH, PaO2 , PaCO, BE had significantly difference.pooled within-groups correlations between discriminating variables, The risk facts are drawn as follows: pregnancy term, degree of cyanose, improvement of PaO /SO (after inhaling higher concentration oxygen), PaCO2 and heart failure.Fisher's linear discriminant functions:PPHN:Y=6.158X,+11.100X2-6.606X3+0.573X4-0.145X-144.028non-PPHN:Y=5.922 X+8.350 X-3.651 X+0.477 X4-2.370 X-127.353(Xi: pregnancy term; X2: degree of cyanose; X3: improvement of PaO /SO (after inhaling higher flow oxygen); X: PaCO2 ; X: heart failure. )Applied in the 30 case patient, if Y>Y2, the patient would be discriminatedto PPHN, otherwise for the non-PPHN. If,we shoud connected with clinical. in this study , the correct ratio of discriminte reached to 95% in the PPHN, non-PPHN was 90%.This study implies that:1. many of perinatal facts, such as pulmonary disease, heart disease, PH, PaC2, PaCO2 , BE, etc, were significantly link with PPHN. those facts which are pregnancy term and degree of cyanose and improvement of PaO2 /SO2(after inhaling high oxygen concentrations); PaCC2 and heart failure were regarded as risk facts for PPHN.. Fisher's linear discriminant functions(Yi and 2 ) can be applied in the clinical, especially in the grass-roots hospital, try to use this function to discriminant PPHN early before transfering patient to higher hospital, catch hold of rescue time, so as to decline or prevent the severe complication of PPHN.