解脲支原体感染与早产儿呼吸系统疾病的相关性

Relativity of Ureaplasma urealyticum in lung disease of prematurity

目的探讨解脲支原体定植在早产儿肺部疾病中的作用。方法对胎齢小于32w的行机械通气的早产儿的气道吸引物进行培养,查找分离解脲支原体,并对阳性组和阴性组进行对照分析。结果143个病例中有39例(27%)分离培养阳性。阳性者呼吸窘迫综合征发生率明显低于阴性者(P=0.002)。多元回归分析显示,在单胎儿中,只有解脲支原体定植是呼吸窘迫症(RDS)的独立预测因子(OR=0.38;P=0.02),胎龄(OR=0.47;P=0.006)和解脲支原体阳性(OR=3.1;P=0.05)都是慢性肺部疾病(CLD)的独立预测因子,这里的CLD是按新法定义的:纠正胎龄达到36周仍需要氧疗。结论解脲支原体气道内定植能预防早产儿发生RDS,但却使早产儿CLD的发病率增加。

Objective： Examine the role of Ureaplasma urealyticum colonisation or infection in neonatal lung disease. Methods： Endotracheal aspirates from ventilated infants less than 32 weeks of gestation were cultured for U urealyticum and outcomes compared in infants with positive and negative cultures. Results： Urealytlcum was isolated from aspirates of 39 of 143 （27%） infants. Respiratory distress syndrome （RDS） occurred significantly less often in colonised, than in non - colonised infants （ P = 0.002 ）. Multivariate logistic regression analysis showed that in singleton infants, ureaplasma colonisation was the only independent （negative） predictor of RDS （ OR 0. 36 ; P = 0. 02）. Both gestational age （ OR 0.46 ; P = 0. 006） and isolation of U urealyticum （ OR 3, 0 ; P = 0. 05） were independent predictors of chronic lung disease （ CLD）, as defined by requirement for supplemental oxygen at 36 weeks of gestational age, Multiple gestation was also a major independent predictor of RDS and CLD. Conclusion： Colonisation or infection with ureaplasma apparently protects premature infants against the development of RDS （suggesting intrauterine infection）. However, in singleton in- fants, it predisposes to development of CLD, independently of gestational age.