不同胎龄嗜酸性粒细胞增多症早产儿的临床特征及发生感染性疾病的影响因素  

Clinical characteristics of premature infants with eosinophilia increase at different gestational ages and influencing factors of infectious diseases

作　　者：夏宁 曾品芳 万鸿[1] Xia Ning;Zeng Pinfang;Wan Hong(Department of Pediatrics,Leshan Maternal and Child Health Hospital of Sichuan Province,Leshan 614000,China)

机构地区：[1]四川省乐山市妇幼保健院儿科,乐山市614000

出　　处：《中华实验和临床感染病杂志(电子版)》2024年第6期350-359,共10页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：乐山市卫生健康委员会(No.22SZD139)。

摘　　要：目的探讨不同胎龄嗜酸性粒细胞(EOS)增多症早产儿的临床特征,发生感染性疾病的影响因素及不同感染性疾病与EOS增多程度的相关性。方法回顾性收集2020年5月至2022年6月乐山市妇幼保健院收治的232例EOS增多早产儿作为研究对象,根据胎龄分为极早产组50例(27周≤胎龄<32周)、中期早产组58例(32周≤胎龄<34周)和晚期早产组124例(34周≤胎龄<37周)。按1︰1︰1倾向性匹配后,3组患者均为48例。比较匹配后3组患儿性别、产妇围生期高危因素、肺出血、剖宫产、抗菌药物使用、机械通气、输血、白细胞升高、胃肠道异常表现、宫内窒息、母亲情况、感染性疾病、多胎、胎膜早破、妊娠糖尿病、妊娠高血压、羊水污染、前置胎盘、宫内感染、喂养不耐受、出生胎龄、出生体重、出生头围、出生身长、母亲年龄、胎龄、出生体重、出生头围、出生身长、降钙素原(PCT)、白细胞介素6(IL-6)和肿瘤坏死因子α(TNF-α)。根据是否发生感染性疾病,将匹配后的144例患儿分为感染性疾病组(41例)和非感染性疾病组(103例),比较该两组患儿出生体重、出生头围、出生身长、剖宫产、多胎、宫内窒息、胎膜早破、妊娠糖尿病、妊娠高血压、羊水污染、前置胎盘、宫内感染、PCT、IL-6、TNF-α、胎龄和EOS计数。采用Logistic回归分析EOS增多患儿发生感染性疾病的影响因素;采用平滑曲线拟合分析早产儿EOS增多程度与常见感染性疾病发生率的曲线关系并进行阈值效应分析。结果匹配后,极早产组、中期早产组和晚期早产组患儿胎龄(F=18.633、P<0.001)、出生体重(F=5.387、P<0.001)、出生头围(F=4.330、P<0.001)、出生身长(F=4.708、P<0.001)、剖宫产(χ^(2)=8.792、P=0.012)、抗菌药物使用(χ^(2)=13.580、P=0.001)、感染性疾病[坏死性小肠结肠炎(χ^(2)=6.257、P=0.043)、败血症(χ^(2)=7.412、P=0.024)、脑膜炎(χ^(2)=7.304、P=0.026)Objective To explore the clinical characteristics of premature infants with eosinophilia(EOS)increase at different gestational ages,the influencing factors of infectious diseases and the correlation between incidences of different infectious diseases and the degree of EOS increase.Methods Total of 232 cases of EOSincreased preterm infants admitted to Leshan Maternal and Child Health Hospital from May 2020 to June 2022 were collected,retrospectively.According to the gestational age,the preterm infants were divided into the very preterm group(27 weeks≤gestational age<32 weeks),the middle preterm group(32 weeks≤gestational age<34 weeks)and the late preterm group(34 weeks≤gestational age<37 weeks),which were 50,58 and 124 cases,respectively.After matching according to 1︰1︰1 tendency,there were 48 cases in every group.Gender,perinatal high maternal factors,pulmonary hemorrhage,cesarean section,antibiotic use,mechanical ventilation,blood transfusion,leukocyte increase,gastrointestinal abnormalities,intrauterine asphyxia,maternal conditions,infectious diseases,multiple fetuses,premature rupture of membranes,gestational diabetes mellitus,gestational hypertension,amniotic fluid contamination,placenta previa,intrauterine infection,feeding intolerance and birth gestational age,birth weight,birth head circumference,birth length,maternal age,gestational age,birth weight,birth head circumference,birth length,procalcitonin(PCT),interleukin-6(IL-6)and tumor necrosis factorα(TNF-α)of the three groups were compared,respectively.According to whether complicated with infectious diseases,144 matched children were divided into infectious disease group(41 cases)and non-infectious disease group(103 cases).Birth weight,birth head circumference,birth length,cesarean section,multiple births,intrauterine asphyxia,premature rupture of membranes,gestational diabetes mellitus,gestational hypertension,amniotic fluid contamination,placenta previa,intrauterine infection,PCT,IL-6,TNF-α,gestational age and EOS count were compared betwe

关 键 词：早产儿 嗜酸性粒细胞 感染性疾病 危险因素 

分 类 号：R722.6[医药卫生—儿科]