气道分泌物解脲支原体阳性早产儿临床特征分析  

Clinical characteristics of premature infants with respiratory ureaplasma urealyticum infection

作　　者：郑淮武 张丽娟[1] 温清华 朱晓连 莫洁洁 林吉涛[1] 钟旭英 万胜明[1] Zheng Huaiwu;Zhang Lijuan;Wen Qinghua;Zhu Xiaolian;Mo Jiejie;Lin Jitao;Zhong Xuying;Wan Shengming(Department of Neonatology,People's Hospital of Baoan,Shenzhen 518101,China)

机构地区：[1]深圳市宝安区人民医院新生儿科,深圳518101

出　　处：《中华新生儿科杂志（中英文）》2023年第9期545-549,共5页Chinese Journal of Neonatology

摘　　要：目的探讨胎龄<34周、呼吸道分泌物解脲支原体(ureaplasma urealyticum,UU)阳性早产儿的临床特征。方法本研究为前瞻性研究,采用荧光探针定量聚合酶链反应法检测2017年1月至2021年12月深圳市宝安区人民医院新生儿科收治的胎龄<34周早产儿呼吸道分泌物UU-DNA,根据检测结果分为UU阳性组和UU阴性组,对两组患儿的围产期因素和临床特征进行比较。结果共纳入182例早产儿,呼吸道分泌物UU-DNA阳性59例(32.4%),UU阳性组早产儿胎龄和出生体重低于UU阴性组,阴道分娩率、胎膜早破>18 h和母亲绒毛膜羊膜炎比例高于UU阴性组,差异均有统计学意义(P<0.05)。UU阳性组生后1、24、72 h白细胞计数、中性粒细胞计数、白细胞介素6高于UU阴性组,差异有统计学意义(P<0.05);两组各时间点C反应蛋白和降钙素原差异无统计学意义(P>0.05)。UU阳性组宫内感染性肺炎、支气管肺发育不良发生率高于UU阴性组,新生儿呼吸窘迫综合征发生率低于UU阴性组,差异均有统计学意义(P<0.05);两组脑室内出血、脑室周围白质软化、喂养不耐受、坏死性小肠结肠炎、早产儿视网膜病等发生率差异无统计学意义(P>0.05)。UU阳性组用氧时间长于UU阴性组,差异有统计学意义(P<0.05);两组有创机械通气比例、住院时间比较差异无统计学意义(P>0.05)。结论呼吸道分泌物UU检测阳性的胎龄<34周早产儿经阴道分娩、胎膜早破>18 h、母亲合并绒毛膜羊膜炎比例较高,可表现为白细胞计数、中性粒细胞计数、白细胞介素6升高,以及用氧时间长、宫内感染性肺炎和支气管肺发育不良发生率增加。Objective To study the clinical characteristics of ureaplasma urealyticum(UU)infection in preterm infants with gestational age<34 weeks.Methods From January 2017 to December 2021,premature infants with gestational age<34 weeks admitted to neonatal department of our hospital were enrolled in this prospective cohort study.UU-DNA from respiratory tract samples were examined using quantitative fluorescence polymerase chain reaction method.The infants were assigned into UU(+)group and UU(-)group.Perinatal factors and clinical characteristics were compared between the two groups.Results A total of 182 preterm infants were enrolled,including 59 cases(32.4%)in UU(+)group and 123(67.6%)in UU(-)group.UU(+)group had significantly lower gestational age and birth weight and significantly higher incidences of vaginal delivery,premature rupture of membranes(PROM)>18 h and maternal chorioamnionitis than UU(-)group(P<0.05).Compared with UU(-)group,UU(+)group had significantly higher leucocyte count,neutrophil count and interleukin-6 at 1,24 and 72 h after birth(P<0.05).No significant differences existed in C-reactive protein and procalcitonin between the two groups at each time point(P>0.05).In UU(+)group,the incidences of intrauterine pulmonary infection and bronchopulmonary dysplasia(BPD)were higher and the incidence of respiratory distress syndrome was lower than UU(-)group(P<0.05).No significant differences existed in the incidences of intraventricular hemorrhage,periventricular leukomalacia,feeding intolerance,necrotizing enterocolitis,retinopathy of prematurity between the two groups(P>0.05).UU(+)group had significantly longer duration of oxygen therapy than UU(-)group(P<0.05).No significant differences existed in the duration of invasive mechanical ventilation and hospital stay between the two groups(P>0.05).Conclusions Preterm infants<34 weeks with positive UU in respiratory tract secretions have higher incidences of vaginal delivery,PROM>18 h and maternal chorioamnionitis.Leukocyte and neutrophil count and interleukin-6

关 键 词：早产儿 解脲支原体 围产期疾病 临床特征 

分 类 号：R722.6[医药卫生—儿科]