双胞胎新生儿呼吸窘迫综合征易感性的研究  

Genetic susceptibility to neonatal respiratory distress syndrome in twins

作　　者：杨敏[1,2] 常立文[2] 李文斌[2] 刘伟[2] 容志惠[2] 蔡保欢[2] 王靓[2] 李玮[2] 胡柳宇 

机构地区：[1]十堰市太和医院儿科二病区,湖北十堰442000 [2]华中科技大学同济医学院附属同济医院新生儿科

出　　处：《临床急诊杂志》2016年第12期901-904,共4页Journal of Clinical Emergency

基　　金：国家自然科学基金(No:81170001;81370099)

摘　　要：目的:通过双胎研究探讨遗传因素在新生儿呼吸窘迫综合征(NRDS)发病中的作用。方法:以2010-01-2014-12华中科技大学同济医学院附属同济医院新生儿重症监护室收治的101对双胞胎患儿为研究对象,每对双胞胎中至少有1例患有NRDS。通过产检资料、产科出生记录、胎盘、性别及血型信息来确定卵型,其中单卵双胎40对,异卵双胎61对;比较单卵双胎和异卵双胎患儿NRDS发病率和同患病率的差异。临床资料用计量资料和计数资料描述,计量资料采取非参数检验,计数资料采用χ2检验比较2组资料的差异,所有数据采用Stata 11.0软件包进行分析。结果:单卵双胎组平均胎龄和出生体重分别为(30.94±2.40)周和(1 509±452)g;异卵双胎组分别为(30.86±1.89)周和(1 573±396)g,2组比较差异无统计学意义;单卵双胎组和异卵双胎组胎膜早破时间(定义为≥18h)、母妊娠糖尿病、产前足疗程糖皮质激素使用率、剖宫产率、5min Apgar评分≤8分、性别构成比等指标比较均差异无统计学意义。40对单卵双胎和61对异卵双胎患儿NRDS发病率分别为85%(68/80)和73%(89/122),2组比较差异有统计学意义(χ2=4.050,P<0.05)。单卵双胎组,双胎均发生NRDS的同患病率为70.0%(28/40),而异卵双胎组NRDS同患病率为45.9%(28/61),差异有统计学意义(χ2=5.68,P<0.05)。结论:单卵双胎组患儿NRDS发病率和同患病率均较异卵双胎组高,提示NRDS具有遗传易感性。Objective：To explore the contribution of genetic factors to neonatal respiratory distress syndrome（NRDS）in twin study.Method：One hundred and one pairs of twins admitted into NICU of Tongji Hospital,Tongji Medical College Huazhong University of Science and Technology from January 2010 to December 2014,one or both with NRDS.Zygosity was determined by maternity check data,birth records,histopathological examination of the placenta,gender and blood type information,40 were monozygotic and 61 were dizygotic twins,differences of NRDS incidence and prevalence between monozygotic and dizygotic twins were analyzed.The clinical data were described by measuring or counting,while the measurement data were applied with non-parametric test,the enumeration data were applied with chi-square test to compare the differences between two groups.All data were analyzed by Stata 11.0packages.Result：In monozygotic twins,average gestational age was（30.94±2.40）w,average birth weight was（1 509±452）g;in dizygotic twins,average gestational age was（30.86±1.89）w,average birth weight was（1 573±396）g;between the two groups,there were no statistical significances.In monozygotic and dizygotic twins,PPROM≥18h、maternal diabetes、antenatal corticosteroids、caesarean section、apgar 5≤8、male were no statistical significances.The NRDS incidence of 40 pairs of monozygotic twins was 85%（68/80）,61 pairs of dizygotic twins was 73%（89/122）,between the two groups,there were statistical significances（χ2=4.050,P〈0.05）.NRDS occurred more frequently in both twins when the twins were monozygotic（28/40,70.0%）than when the twins were dizygotic（28/61,45.9%）,This difference was statistically significant（χ2=5.68,P〈0.05）.Conclusion：NRDS incidence and prevalence in monozygotic twins are higher than dizygotic twins,this twin study supportsthe notion of a genetic contribution to NRDS.

关 键 词：双胎研究 单卵双胎 异卵双胎 新生儿呼吸窘迫综合征 遗传易感性 

分 类 号：R72[医药卫生—儿科]