Theilen U, Lyon A J, Fitzgerald T, Hendry G M A, Keeling J W
Simpson Centre for Reproductive Health, Royal Infirmary, Edinburgh, Scotland, UK.
Arch Dis Child Fetal Neonatal Ed. 2004 Mar;89(2):F163-7. doi: 10.1136/adc.2003.026013.
Despite having mild early respiratory disease, many preterm babies develop chronic lung disease (CLD). Intrauterine infection with Ureaplasma urealyticum has been associated with preterm labour and CLD.
To test the hypothesis that infection with U urealyticum results in a specific clinical and radiological picture in the first 10 days of life.
Retrospective study of 60 ventilated babies < 30 weeks gestation, who had tracheal secretions tested for U urealyticum. Placental histology was reviewed by a paediatric pathologist for signs of chorioamnionitis. Chest radiographs were independently reviewed by two paediatric radiologists according to previously agreed criteria. All reviewers were blinded to the infection status of the babies.
Twenty five babies were U urealyticum positive. These were more likely to experience chorioamnionitis (p = 0.004), premature rupture of membranes (p = 0.01), and spontaneous vaginal delivery (p = 0.09). U urealyticum positive babies had fewer signs of respiratory distress syndrome on early chest radiographs (p = 0.038), and they could be weaned from their ventilation settings (fraction of inspired oxygen (FIO(2)) and mean airway pressure) more quickly in the first few days. Subsequently U urealyticum positive babies deteriorated clinically and radiologically. More often they required ventilation to be restarted (p = 0.051), a higher proportion being ventilated on day 10 (p = 0.027) with higher FIO(2) (p = 0.001) and mean airway pressure (p = 0.002). Their chest radiographs showed more emphysematous changes as early as day 5 (p = 0.045), with a pronounced difference by day 10 (p = 0.009).
Preterm ventilated babies with U urealyticum in their tracheal secretions have a different clinical and radiological course, with less acute lung disease but early onset of CLD, compared with those with negative cultures.
尽管许多早产婴儿早期患有轻度呼吸系统疾病，但仍会发展为慢性肺部疾病（CLD）。解脲脲原体宫内感染与早产和CLD有关。
检验解脲脲原体感染在出生后10天内会导致特定临床和影像学表现的假设。
对60例孕周小于30周且接受机械通气的婴儿进行回顾性研究，检测其气管分泌物中的解脲脲原体。由儿科病理学家检查胎盘组织学，以寻找绒毛膜羊膜炎的迹象。两名儿科放射科医生根据先前商定的标准独立审查胸部X光片。所有审查人员均不知晓婴儿的感染状况。
25例婴儿解脲脲原体检测呈阳性。这些婴儿更易发生绒毛膜羊膜炎（p = 0.004）、胎膜早破（p = 0.01）和自然阴道分娩（p = 0.09）。解脲脲原体阳性的婴儿早期胸部X光片上呼吸窘迫综合征的体征较少（p = 0.038），并且在最初几天内能够更快地降低机械通气参数（吸入氧分数（FIO₂）和平均气道压）。随后，解脲脲原体阳性的婴儿在临床和影像学上病情恶化。他们更常需要重新开始机械通气（p = 0.051），在出生第10天进行机械通气的比例更高（p = 0.027），且FIO₂（p = 0.001）和平均气道压更高（p = 0.002）。他们的胸部X光片早在第5天就显示出更多的肺气肿改变（p = 0.045），到第10天差异更为明显（p = 0.009）。
与培养结果为阴性的早产机械通气婴儿相比，气管分泌物中含有解脲脲原体的婴儿具有不同的临床和影像学病程，急性肺部疾病较少，但CLD发病较早。
