临床儿科杂志 ›› 2014, Vol. 32 ›› Issue (9): 843-.doi: 10.3969 j.issn.1000-3606.2014.09.011

• 围产新生儿疾病专栏 • 上一篇    下一篇

组织学绒毛膜羊膜炎与早产儿脑损伤相关性分析

邹志慧, 杨冰岩, 王维琼, 张晓敏, 陈少波, 赖春华, 吕峻峰, 杨春晖, 段立锋   

  1. 中山市博爱医院( 广东中山 528400)
  • 收稿日期:2014-09-15 出版日期:2014-09-15 发布日期:2014-09-15
  • 通讯作者: 邹志慧 E-mail:292451854@qq.com
  • 基金资助:
    中山市卫生局项目(No.J2011084)

A correlational analysis of histological chorioamnionitis and brain injury in preterm infants

ZOU Zhihui, YANG Bingyan, WANG Weiqiong, ZHANG Xiaomin, CHEN Shaobo, LAI Chunhua, LU Junfeng, YANG Chunhui, DUAN Lifeng   

  1. Neonatal Department, Bo'ai Hospital, Zhongshan 528400, Guangdong, China
  • Received:2014-09-15 Online:2014-09-15 Published:2014-09-15

摘要:  目的 探讨组织学绒毛膜羊膜炎(HC)及合并胎儿血管炎(FV)时与早产儿脑损伤的相关性。方法 回顾性分析347例住院的出生胎龄28~32周早产儿的临床资料。根据病理检查结果将早产儿分为HC组和对照组,HC组再根据是否合并胎儿血管炎分FV组及无FV组。早产儿定期行头颅B超检查,比较早产儿脑室周围白质软化(PVL)、脑室周围-脑室内出血(PVH-IVH)和脑室周围白质软化并脑室周围-脑室内出血的发生情况。结果 HC组、对照组PVL发生率分别为17.9%、10.4%,PVL合并PVH-IVH发生率分别为5.5%、1.5%,差异均有统计学意义(P<0.05);而PVH-IVH 的发生率分别为29.0%、26.2%,差异无统计学意义(P>0.05)。在HC组中,FV组、无FV组的PVL发生率则分别28.1%、9.9%,差异有统计学意义(P<0.05); PVH-IVH 的发生率为34.3%、24.7%,PVL合并PVH-IVH发生率分别为7.8%、3.7%,差异均无统计学意义(P>0.05)。结论 HC可使早产儿PVL、PVL合并PVH-IVH的发生率增加,而对PVH-IVH 的影响不大,合并FV会增加早产儿脑损伤发生率。

Abstract: Objective To explore the correlation between histological chorioamnionitis (HC) and brain injury in preterm infants. Methods Three hundred and forty-seven cases of infants at the gestational age of 28-31 weeks who were admitted to the neonatology department of our hospital were analyzed retrospectively. They were divided into the HC group and the control group according to the pathological examination. Moreover, HC group was divided into FV group and non-FV group according to the pathological findings of fetal vasculitis (FV). Based on the findings of periodical ultrasonography, the incidences of periventricular leukomalacia (PVL), periventricular-intraventricular hemorrhage (PVH-IVH), and the PVL+PVH-IVH were compared among groups. Results The incidences of PVL in the HC group and the control group were 17.9% and 10.3% respectively. The incidences of PVL+PVH-IVH in the two groups were 5.5% and 1.48% respectively, and the difference between two groups was significant (P<0.05). The incidences of PVH-IVH in the two groups were 28.9% and 26.2% respectively, and the difference between two groups was not significant (P>0.05). In the HC group, the incidences of PVL in FV group and non-FV group were 28.1% and 9.87% respectively, and the difference between two groups was significant (P<0.05). The incidences of PVH-IVH in FV group and non-FV group were 34.3% and 24.7% respectively, and the difference between two groups was not significant (P>0.05). The incidences of PVL+PVH-IVH in FV group and non-FV group were 7.81% and 3.70% respectively, and the difference between the two groups was not have significant (P>0.05). Conclusions HC may increase the ncidences of PVL and PVL+PVH-IVH in the preterm infants, while its effect is minimal on PVH-IVH. FV could increase the incidence of brain injury in preterm infants.