重度支气管发育不良早产儿下呼吸道分泌物分离菌的分布特点  

Distribution characteristics of bacteria isolated from lower respiratory tract secretions of premature infants with severe bronchopulmonary dysplasia

作　　者：谷名晓 刘选成 李跃 单若冰 GU Mingxiao;LIU Xuancheng;LI Yue;SHAN Ruobing(Neonatal Medical Center of Qingdao Women and Children's Hospital,Qingdao 266034,China)

机构地区：[1]青岛市妇女儿童医院新生儿中心,266034

出　　处：《天津医药》2023年第1期78-81,共4页Tianjin Medical Journal

基　　金：青岛市2019年度医药科研指导计划项目(2019-WJZD129)。

摘　　要：目的 通过分析支气管肺发育不良(BPD)的早产儿下呼吸道分离菌的特点,探讨该病菌与重度支气管肺发育不良的相关性。方法 选取新生儿重症监护病房(NICU)诊断为BPD的185例有创机械通气≥72 h的患儿为研究对象,根据病情严重程度分为轻中度组(124例)和重度组(61例)。收集患儿的出生体质量、胎龄等一般临床资料,以及坏死性小肠结肠炎、败血症、呼吸机相关性肺炎(VAP)等新生儿疾病治疗过程指标。收集2组的呼吸道吸取液(TAF)行病原培养并进行统计学分析。结果 与轻中度组相比,重度组患儿的出生体质量、胎龄更小(P<0.05),TAF检出革兰阴性菌、肺炎克雷伯菌、铜绿假单胞菌及棒状杆菌患儿的比例升高(P<0.05)。结论 早产儿下呼吸道菌群的改变可能是BPD进展的重要因素,重度BPD患儿TAF中检测到肺炎克雷伯菌、铜绿假单胞菌及棒状杆菌的比例更高。Objective To analyze the characteristics of bacteria isolated from lower respiratory tract in premature infants with severe bronchopulmonary dysplasia(BPD),and to explore the correlation between the bacteria and BPD.Methods A total of 185 preterm infants diagnosed as BPD in the neonatal intensive care unit(NICU) with invasive mechanical ventilation≥72 h were enrolled in the study.Patients were divided into the mild moderate BPD group(n=124)and the severe BPD group(n=61) according to the severity of the disease.The general clinical data such as birth weight and gestational age were collected,as well as the treatment process indicators of neonatal diseases such as necrotizing enterocolitis,sepsis and ventilator-associated pneumonia(VAP).Respiratory aspirate fluid(TAF) samples from 2 groups were collected for pathogen culture and statistically analyzed.Results Compared with the mild moderate group,birth weight and gestational age were lower in the severe group(P <0.05),and the proportion of children with gram-negative bacteria,Klebsiella pneumoniae,Pseudomonas aeruginosa and Corynebacterium detected by TAF were increased(P <0.05).Conclusion Changes of lower respiratory tract flora in preterm infants may be an important factor in the development of BPD,and the proportion of Klebsiella pneumoniae,Pseudomonas aeruginosa and Corynebacterium detected in TAF of children with severe BPD is higher.

关 键 词：支气管肺发育不良 婴儿 早产 呼吸道感染 细菌 呼吸道分泌物 有创通气 

分 类 号：R725.639[医药卫生—儿科]