临床儿科杂志 ›› 2016, Vol. 34 ›› Issue (1): 1-.doi: 10.3969 j.issn.1000-3606.2016.01.001

• 传染感染性疾病专栏 •    下一篇

34 周以下早产儿解脲脲原体感染临床特征分析

郑拉洁,苏卫东,黄育丹   

  1. 温州市儿童医院新生儿科( 浙江温州 325000)
  • 收稿日期:2016-01-15 出版日期:2016-01-15 发布日期:2016-01-15
  • 通讯作者: 郑拉洁 E-mail:rachel870928@163.com

Analysis of the clinical features of Ureaplasma urealyticum infection in preterm infants under 34 weeks’ gestation

ZHENG Lajie,SU Weidong,HUANG Yudan   

  1. Department of Neonatology, The Wenzhou Children's Hospital, Wenzhou 325000, Zhejiang, China
  • Received:2016-01-15 Online:2016-01-15 Published:2016-01-15

摘要: 目的 探讨<34 周早产儿解脲脲原体(UU) 感染的临床特征。方法 选取232 例<34 周早产儿,用实时荧光定量聚合酶链反应法检测入院24 h 内下呼吸道分泌物中UU,并分为阳性和阴性组,比较其临床特征的差异。结果 232例早产儿中,UU 阳性97 例;阳性组平均胎龄和出生体质量均低于阴性组,差异有统计学意义(P 均<0.01)。两组间性别、母亲妊娠期高血压、产前使用激素、围生期窒息的差异无统计学意义(P>0.05),阳性组母亲绒毛膜羊膜炎、胎膜早破、经阴道分娩率均高于阴性组,差异有统计学意义(P<0.01)。生后24 h、72 h,阳性组的白细胞及中性粒细胞计数均较阴性组增高,差异有统计学意义(P<0.05)。阳性组出生1 周后肺部损伤较阴性组明显,差异有统计学意义(P<0.05)。阳性组呼吸机撤机后需重新机械通气,以及第10 天仍需机械通气的比例高于阴性组,差异有统计学意义(P 均<0.05)。出生28 d 时,阳性组支气管肺发育不良发生率高于阴性组,急性呼吸窘迫综合征发生率低于阴性组,差异均有统计学意义(P均<0.05);两组间早产儿视网膜病、脑室内- 脑室周围出血、脑室周白质软化、新生儿坏死性小肠结肠炎及出院时宫外发育迟缓发生率的差异无统计学意义(P>0.05)。结论 <34 周以下早产儿下呼吸道分泌物UU 检测阳性可能与早产、低出生体质量有关,并可引起慢性肺部损伤。

Abstract:  Objective To investigate the clinical features of Ureaplasma urealyticum (UU) infection in preterm infants under 34 weeks’ gestation. Methods A total of 232 preterm infants under 34 weeks’ gestation were enrolled. The UU in the lower respiratory tract secretions from infants within 24 hours of admission were detected by real-time fluorescence quantitative polymerase chain reaction. According to the results, infants were divided into positive and negative groups. The differences of the clinical features were compared between two groups. Results Ninety-seven infants were UU positive in 232 preterm infants. The gestational age and birth weight of the positive group were lower than those of negative group (all P<0.01). The difference in sex, maternal gestational hypertension, prenatal use of hormones and perinatal asphyxia between two groups were not significant (P>0.05). The rates of histologic chorioamnionitis, premature rupture of membranes and vaginal delivery in the positive group were higher than those in the negative group (P<0.01). At 24 and 72 hours after birth, the number of leukocytes and neutrophils in the positive group were significantly higher than those in the negative group (P<0.05). One week after birth, the lung injury was more serious in the positive group than that in the negative group (P<0.05). The rates of re-ventilation during ventilator weaning and needs of ventilator after 10 days were higher in the positive group than those in the negative group. At 28 days after birth, the rate of the bronchial dysplasia was higher in the positive group than that in the negative group (P< 0.05) and the rate of acute respiratory distress syndrome was lower in the positive group than that in the negative group (P<0.05). The rates of retinopathy, periventricular-intraventricular hemorrhage, periventricular leukomalacia, neonatal necrotizing enterocolitis and extrauterine growth retardation were not different between the two groups (all P<0.01). Conclusions The presence of UU in lower respiratory tract secretions in preterm infants under 34 weeks’ gestation may be associated with premature birth and low birth weight, and may cause chronic lung injury.