母亲人类免疫缺陷病毒感染状态对新生儿坏死性小肠结肠炎结局的影响。

Effect of maternal human immunodeficiency virus status on the outcome of neonates with necrotizing enterocolitis.

机构信息

Department of Pediatric Surgery, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town 7701, South Africa.

出版信息

J Pediatr Surg. 2010 Feb;45(2):315-8; discussion 318. doi: 10.1016/j.jpedsurg.2009.10.068.

DOI:10.1016/j.jpedsurg.2009.10.068

PMID:20152343

Abstract

AIM

The aim of the study was to assess the impact of human immunodeficiency virus (HIV) exposure on survival and extent of disease in necrotizing enterocolitis (NEC).

PATIENTS AND METHODS

All patients with NEC requiring surgery between June 1998 and June 2008 were analyzed. Three groups were identified: those born to HIV-positive (HIV+) mothers, those born to HIV-negative (HIV-) mothers, and those with an unknown HIV status. Primary outcome measure was survival to discharge. Secondary outcome measure was extent of disease.

RESULTS

One hundred nine infants (mean gestational age, 31 weeks; birth weight, 1413 g) underwent surgery for NEC. Gestational age, birth weight, and day of presentation were similar in all 3 groups, showing no statistical difference. The HIV+ group consisted of 22 infants, of which 13 (59%) died and 2 (9%) had panintestinal necrosis. The HIV- group consisted of 48 infants, of which 11 (23%) died, with 3(6%) having panintestinal necrosis. The remaining group of HIV (unknown) consisted of 38 infants, of which 14 (37%) died, with 2 (5%) having panintestinal necrosis. The latter group was not included in the analysis; but comparing the HIV+ and HIV- groups, there was a statistically higher chance of death (odds ratio = 4.8, P = .05). There was no difference statistically in the extent of disease.

CONCLUSION

Neonates with NEC born to HIV+ mothers have a higher mortality.

摘要

目的

本研究旨在评估人类免疫缺陷病毒（HIV）暴露对坏死性小肠结肠炎（NEC）患者生存和疾病严重程度的影响。

患者和方法

分析了 1998 年 6 月至 2008 年 6 月间所有需要手术治疗的 NEC 患儿。将患儿分为三组：HIV 阳性（HIV+）母亲所生患儿、HIV 阴性（HIV-）母亲所生患儿和 HIV 状态未知患儿。主要观察指标为出院时的生存率。次要观察指标为疾病严重程度。

结果

109 例婴儿（平均胎龄 31 周，出生体重 1413g）因 NEC 接受了手术治疗。三组患儿的胎龄、出生体重和发病日龄相似，无统计学差异。HIV+组有 22 例患儿，其中 13 例（59%）死亡，2 例（9%）出现全肠坏死。HIV-组有 48 例患儿，其中 11 例（23%）死亡，3 例（6%）出现全肠坏死。HIV 状态未知的患儿有 38 例，其中 14 例（37%）死亡，2 例（5%）出现全肠坏死。后一组未纳入分析；但比较 HIV+和 HIV-组，HIV+组患儿死亡的几率更高（比值比=4.8，P=0.05）。两组患儿疾病严重程度无统计学差异。