组织学绒毛膜羊膜炎及胎儿血管炎对新生儿呼吸窘迫综合征发生率的影响  

The relationship between histological chorioanmionitis,fetal vasculitis and the morbidity of neonatal respiratory distress syntlrollae

作　　者：张莉[1] 周涛[1] 邹志慧[1] 杨冰岩[1] 王维琼[1] 张晓敏[1] 陈少波[1] 赖春华[1] 

机构地区：[1]南方医科大学附属中山市博爱医院儿科,528400

出　　处：《中国小儿急救医学》2015年第7期482-485,共4页Chinese Pediatric Emergency Medicine

摘　　要：目的探讨组织学绒毛膜羊膜炎（11istological chorioamnionitis，HC）、胎儿血管炎（fetal vasculitis，FV）及HC合并FV与新生儿呼吸窘迫综合征（respiratory distress syndrome，RDS）的相关性。方法回顾性分析2009年lO月至2013年6月在我院新生儿科住院的胎龄28^＋0-31^＋6周的347例早产儿的临床资料，根据病理检查结果分为HC阳性组和Hc阴性组，FV阳性组和FV阴性组，Hc阳性组再根据是否合并FV，分为FV阳性组及FV阴性组；比较上述各组间RDS的发生情况。结果各组间临床资料，包括男性比例，出生胎龄，体重，剖宫产率，产前激素应用比例，其母妊娠期高血压、妊娠期糖尿病及妊娠期胆汁淤积的发生率，经统计学分析差异均无统计学意义（P〉0．05）；HC阳性组（145例）RDS发生率为49．6％（72例），HC阴性组（202例）RDS发生率为67．3％（136例），HC阳性组RDS发生率明显低于HC阴性组（P〈0．05）；FV阳性组（64例）RDS发生率42．2％（27例），FV阴性组（283例）RDS发生率63．3％（179例），FV阳性组RDS发生率明显低于FV阴性组（P〈0．05）；HC阳性FV阳性组（64例）RDS发生率42．2％（27例），HC阳性FV阴性组（81例）RDS发生率55．6％（45例），两组间RDS发生率差异无统计学意义（P：0．11）。结论（1）HC、FV均可降低早产儿RDS的发生率。（2）HC合并FV未进一步降低早产儿RDS的发生率。Objective To explore the relationship between histological chorioamnionitis（HC） ,fetal vasculitis （FV） and the morbidity of neonatal respiratory distress syndrome（RDS）. Methods Three hundred and forty-seven cases of infants at the gestational ages of 28 ^＋0 to 31^＋6 weeks who were admitted to the Neonatology Department of our hospital from October 2009 to June 2013 were analyzed retrospectively. They were divided into four groups according to the occurrence of HC and FV ,namely ,HC positive group and HC negative group, FV positive group and FV negative group. The patients in the HC positive group were further divided into FV positive group and FV negative group according to the occurrence of FV. The morbidity of RDS among above-mentioned groups was compared. Results The clinical characteristics including proportion of male, gestational age,birth weight,cesarean delivery, antenatal corticosteroid use, gestational hypertension, gestational diabetes and cholestasis of pregnancy showed no statistically significant difference among all the groups（P 〉 0. 05）. The incidence of RDS in the HC positive group（ 145 cases） was 49. 6% （72 cases）, which was significantly lower than that in the HC negative group （67.3%, 126/202, P 〈 0. 05）. The incidence of RDS in FV positive group（64 cases） was 42. 2% （27 cases） ,which was significantly lower than that in FV negative group （63.3%, 179/283, P 〈 0. 05 ） In the HC positive group （145 cases）, the incidence of RDS in FV positive group （ 64 cases） was 42. 2% （ 27 cases）, and 55.6% （45 cases） in FV negative group （81 cases） , which showed no significant difference（ P = 0.01 ）. Conclusion （ 1 ） HC or FV can reduce the incidence rate of RDS in premature infants. （2） HC combined FV cannot furtherly reduce the incidence of RDS.

关 键 词：组织学绒毛膜羊膜炎 胎儿血管炎 新生儿呼吸窘迫综合征 

分 类 号：R722.1[医药卫生—儿科]