早产儿解脲脲原体定植的特征分析及红霉素治疗评估的临床研究  

Clinical study on the characteristics of ureaplasma urealyticum colonization in premature infants and the evaluation of erythromycin treatment

作　　者：陶鸣燕 王鲁春 牛利美 吴薇敏 万俊[1] 包志丹 TAO Mingyan;WANG Luchun;NIU Limei;WU Weimin;WAN Jun;BAO Zhidan(Department of Pediatrics,Jiangyin Hospital Affiliated to Nantong University,Jiangyin,Jiangsu 214400,China)

机构地区：[1]南通大学附属江阴医院新生儿科,江苏江阴214400

出　　处：《检验医学与临床》2023年第S02期84-89,共6页Laboratory Medicine and Clinic

摘　　要：目的探讨呼吸道解脲脲原体(UU)定植早产儿的临床特点及红霉素治疗后的临床疗效和预后。方法纳入2017年4月至2022年4月在该院新生儿重症监护室住院的胎龄<34周的早产儿232例,出生48 h内完善下呼吸道分泌物UU PCR检测,根据结果分为UU阳性组和UU阴性组,阳性组分为红霉素治疗组及未治疗组,回顾性分析UU定植早产儿的临床特征,比较治疗组及未治疗组炎症指标、用氧时间、合并疾病及神经行为发育预后。结果UU阳性组胎膜早破比例、阴道分娩率、支气管肺发育不良发生率、总用氧时间高于UU阴性组,胎龄、出生体重小于UU阴性组,差异有统计学意义(P<0.05);两组在性别、多胎,妊娠期糖尿病、产前激素、妊娠期高血压、绒毛膜羊膜炎,新生儿期合并疾病、气管插管比例、使用肺表面活性物质比例差异无统计学意义(P>0.05)。UU阳性治疗组和未治疗组围生期临床资料、气管插管比例、应用肺表面活性物质比例、有创机械通气时间差异无统计学意义(P>0.05),总用氧时间治疗组较未治疗组缩短(P<0.05)。治疗组早产儿患中重度支气管肺发育不良比例低于未治疗组(P<0.05)。两组治疗前IL-6、IL-8水平无统计学意义(P>0.05),治疗后IL-6、IL-8水平治疗组低于未治疗组(P<0.05)。出院后随访至纠正6月龄,两组患儿的发育商、大运动、精细动作、适应能力、语言、社会行为得分差异无统计学意义(P>0.05)。结论UU定植与早产、阴道分娩、胎膜早破、低出生体重密切相关,对UU定植早产儿使用红霉素治疗,有助于降低中重度支气管肺发育不良的发生风险,对早产儿早期神经行为发育无显著影响。Objective To analyze the clinical characteristics of premature infants with ureaplasma urealyticum(UU)colonization as well as the clinical efficacy after erythromycin treatment.Methods A total of 232 premature infants with gestational age less than 34 weeks who were hospitalized in the hospital from April 2017 to April 2022 were recruited.UU PCR of of lower respiratory tract secretion was carried out within 48 hours of birth.According to the UU PCR results,all the infants were divided into UU positive groupand UU negative group.The UU positive group was divided into erythromycin treatment group and non-treatment group.The clinical characteristics of preterm infants with UU colonization were retrospectively analyzed,and indicators of inflammation,duration of oxygen use,co-morbidities,and neurobehavioral developmental prognosis were compared between the treated and untreated groups.Results The incidence of premature rupture of membranes,transvaginal delivery rate,incidence of bronchopulmonary dysplasia,and total oxygen use time were significantly higher in the UU-positive group than in the UU-negative group,and the gestational age at birth was smaller in the UU-positive group than in the UU-negative group.Birth weight was significantly lower than that of the UU-negative group(P<0.05).There is no significant difference in sex composition,multiparous,intrauterine growth retardation,Apgar scores,maternal gestational diabetes,prenatal use of dexamethasone,gestational hypertension,gestational chorioamnionitis,co-morbidities in the neonatal period,proportion of tracheal intubation,the proportion of alveolar surfactant used in two groups(P>0.05).There was no statistical difference in the perinatal clinical data,proportion of tracheal intubation,proportion of application of pulmonary surfactant,and duration of invasive mechanical ventilation between UU-positive treated and untreated groups(P>0.05),and the total duration of oxygen use was shorter in the treated group than in the untreated group(P<0.05).The proportion of pre

关 键 词：解脲脲原体 早产儿 红霉素 支气管肺发育不良 

分 类 号：R446.5[医药卫生—诊断学]