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解脲脲原体在早产儿支气管肺发育不良中的临床意义

[Clinical significance of Ureaplasma urealyticum in bronchopulmonary dysplasia of prematurity].

作者信息

Bao Yu, Zhao Zheng-yan, Shi Li-ping, Ma Xiao-lu, Chen Zheng, Luo Fang

机构信息

Neonatal Intensive Care Unit, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.

出版信息

Zhonghua Er Ke Za Zhi. 2012 Oct;50(10):767-70.

Abstract

OBJECTIVE

To investigate the association of Ureaplasma urealyticum (UU) infection with the incidence of bronchopulmonary dysplasia (BPD), to compare the clinical manifestations and prognosis of BPD infants with or without Ureaplasma urealyticum infection.

METHOD

Data were retrospectively collected between January 2004 and June 2011. All infants whose gestational age was ≤ 32 w and survived at 36 w were included in this study. Endotracheal aspirates were collected for UU polymerase chain reaction (PCR) within the first 48 hr of life. Statistical analyses were performed by using SPSS 11.5 software. The clinical characteristics of infants in the two groups were compared. The association of UU infection and BPD was analyzed and the clinical manifestations and prognosis of BPD in the two groups were compared.

RESULT

The results of PCR for UU were positive while that for other pathogens were negative in 168 infants whose chest X rays confirmed pulmonary inflammatory changes (UU group). The results of PCR for UU were negative in 393 infants (non-UU group). Except for premature rupture of membranes >24 hr, the rates of vaginal delivery, neonatal respiratory distress syndrome (NRDS) and surfactant use, there was no significant difference in the demographics and other baseline clinical characteristics of the two groups. The incidence of BPD was higher in UU group than in non-UU group and there was statistically significant difference in severity of BPD (P = 0.044, 0.031). The infants had been followed up until they were 1 year old. Compared to infants in non-UU group, infants in UU group showed no significant differences in the rate of death of pulmonary infection in moderate and severe BPD infants, the same as the rates of BPD infants hospitalized again or hospitalized more than 2 times because of pulmonary infection or/and wheezing episode in the first year after birth.

CONCLUSION

Preterm infants infected with UU were more likely to have BPD than non-UU infants. BPD infants associated with UU infection were more severe than that in non-UU infants. Prognosis of BPD infants associated with UU infection was similar to that of the infants whose BPD was not associated with UU infection.

摘要

目的

探讨解脲脲原体(UU)感染与支气管肺发育不良(BPD)发生率的关系,比较UU感染与未感染的BPD婴儿的临床表现及预后。

方法

回顾性收集2004年1月至2011年6月间的数据。本研究纳入所有胎龄≤32周且在36周时存活的婴儿。在出生后48小时内收集气管内吸出物进行UU聚合酶链反应(PCR)检测。采用SPSS 11.5软件进行统计分析。比较两组婴儿的临床特征。分析UU感染与BPD的相关性,并比较两组BPD的临床表现及预后。

结果

168例胸部X线证实有肺部炎症改变的婴儿UU PCR检测结果为阳性,而其他病原体检测结果为阴性(UU组)。393例婴儿UU PCR检测结果为阴性(非UU组)。除胎膜早破>24小时、阴道分娩率、新生儿呼吸窘迫综合征(NRDS)及表面活性剂使用率外,两组的人口统计学特征及其他基线临床特征无显著差异。UU组BPD的发生率高于非UU组,且BPD严重程度差异有统计学意义(P = 0.044,0.031)。对婴儿随访至1岁。与非UU组婴儿相比,UU组中度和重度BPD婴儿肺部感染死亡率、出生后第一年因肺部感染或/和喘息发作再次住院或住院超过2次的BPD婴儿比例无显著差异。

结论

感染UU的早产儿比未感染UU的婴儿更易发生BPD。与UU感染相关的BPD婴儿比非UU感染的婴儿病情更严重。与UU感染相关的BPD婴儿预后与非UU感染的BPD婴儿相似。

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