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目的探讨患有新生儿呼吸窘迫综合征(RDS)的极低出生体重儿下呼吸道分泌物解脲脲原体(UU)感染与支气管肺发育不良(BPD)的关系。方法选择淮安第一医院2012年1月~2014年12月间收治的110例患有RDS、行早期机械通气(MV)治疗且至少应用1剂PS(肺表面活性物质)的极低出生体重儿(VLBWI),检测气管内吸出物UU核酸,分为感染组(32例)和未感染组(78例),比较两组临床表现和BPD发生率。结果较之未感染组,感染组胎膜早破(PROM)发生率、阴道产百分率及反复院内肺部感染发生率均升高;感染组PROM持续时间、吸氧时间和住院时间均显著长于未感染组。感染组生后3 h内血浆Ig M、白细胞计数(WBC)、中性粒细胞绝对值(ANC)显著高于未感染组。110例患儿中,发生BPD 68例,其中感染组BPD 29例,发生率为90.6%,未感染组BPD 39例,发生率为50%,感染组显著高于未感染组(P<0.01)。结论下呼吸道解脲脲原体感染可增加新生儿RDS极低出生体重儿BPD发生率。
Objective To investigate the relationship between UU infection and bronchopulmonary dysplasia (BPD) in lower respiratory tract secretions of very low birth weight infants with neonatal respiratory distress syndrome (RDS). Methods One hundred and ten cases of very low birth weight infants with RDS who underwent early mechanical ventilation (MV) with at least one dose of PS (pulmonary surfactant) were enrolled in the First Affiliated Hospital of Huaian from January 2012 to December 2014. (VLBWI). UU nucleic acid was detected in trachea and divided into infection group (n = 32) and uninfected group (n = 78). The clinical manifestations and the incidence of BPD were compared between the two groups. Results Compared with uninfected group, the incidences of PROM, vaginal delivery and repeated nosocomial pulmonary infections were all significantly higher in infected group than in uninfected group. The duration of PROM, oxygen inhalation and hospital stay in infection group were significantly longer than those in uninfected group Infected group. Plasma Ig M, WBC and ANC in the infected group were significantly higher than those in the uninfected group within 3 h. Of the 110 cases, BPD occurred in 68 cases, of which BPD was found in 29 cases (90.6%) in the infected group and 39 cases (BPD) in the uninfected group (50%). The BPD in the infected group was significantly higher than that in the uninfected group (P <0.01) . Conclusion The lower respiratory tract Ureaplasma urealyticum infection can increase the incidence of BPD in very low birth weight infants with RDS.