关键词: 早产儿, 　脑损伤, 　流行病学

Abstract: Objective　To explore the clinical features of brain damage in premature infants. Method　The clinical data of premature infants with brain injury (including cerebral infarction, cerebral edema, intracranial hemorrhage, white matter injury and basal nerve nucleus injury) were retrospectively analyzed. The subjects were the infants admitted to the neonatal department of nine hospitals in Jiangsu Province from March 1, 2015 to February 29, 2016. Results　In 9239 preterm infants, 2515 (27.22%) met the diagnosis of brain injury, including 1406 males and 1109 females with an average gestational age at 31.2±2.8 weeks and an average birth weight being 1 825.6±819.8 g. Periventricular-intraventricular hemorrhage was the most common type of hemorrhagic brain injury in premature infants, accounting for 67.57%. Non-hemorrhagic brain injury was mainly edema (50.93%) and periventricular leukomalacia (37.94%). Periventricular-intraventricular hemorrhage (PVH-IVH) and periventricular leukomalacia (PVL) were mostly in grade Ⅰ and Ⅱ in classification. There were significant differences in gestational age, birth weight, sex, Apgar score and delivery mode among premature infants with white matter injury, basal nerve nucleus injury, cerebral infarction, brain edema and intracranial hemorrhage (all P<0.05). Among them, a higher proportion of infants having gestational age <32 weeks existed in children with white matter damage; a higher proportion of infants having birth weight <1500 g existed in children with white matter damage, cerebral infarction and intracranial hemorrhage, and a higher rate of birth weight between 1500-2500 g existed in children with basal ganglia injury and cerebral edema. The rate of Apgar score < 3 was higher in children with cerebral infarction, while it was lower in children with intracranial hemorrhage. A higher proportion of cesarean section was in Cerebral infarction children. The improvement rate of brain injury in premature infants was 89.34%. Conclusions  PVH-IVH was the most common type of hemorrhagic brain injury, while PVL was the main type of non-hemorrhagic brain injury. PVH-IVH and PVL are mostly in grade Ⅰ and Ⅱ in classification. Low Apgar score, small gestational age and low birth weight were important risk factors for brain injury in premature infants.

Key words: 　premature infant, 　brain injury, 　epidemiology