绒毛膜羊膜炎及脐带炎暴露与早产儿生后常见疾病的相关性研究

Study on the correlation between exposure to chorioamnionitis or funisitis and common diseases in premature infants

目的分析绒毛膜羊膜炎及脐带炎与早产儿生后常见疾病的相关性。方法选取在本院产科分娩且住新生儿科<34周早产儿151例,根据胎盘病理结果分为绒毛膜羊膜炎(CA)(-)脐带炎(FV)(-)组33例,CA(+)FV(-)组61例,CA(+)FV(+)组57例,收集孕妇及患儿围生期相关资料,比较各组患儿生后常见疾病发生率及各感染指标差异。结果 3组比较,各疾病发生率随炎症进展逐渐增高,且肺炎、呼吸窘迫综合征(RDS)、颅内出血、坏死性小肠结肠炎(NEC)发生率差异有统计学意义(P<0.05)。母亲产前发热、白细胞数、C反应蛋白及新生儿降钙素原各组比较差异有统计学意义(P<0.05),且随感染指标增高,CA及FV发生率随之增高,而产前中性粒细胞百分比及患儿感染指标差异均无统计学意义(P>0.05)。结论绒毛膜羊膜炎、脐带炎暴露时,可导致早产儿生后常见疾病发生率增加,且与肺炎、RDS、NEC发生密切相关。母亲产前C反应蛋白(CRP)及早产儿生后新生儿降钙素原(PCT)水平可作为预测绒毛膜羊膜炎发生的一项指标。

Objective To investigate the relationship between chorioamnionitis or funisitis and diseases in preterm in- fants with gestational age less than 34 weeks. Method A total of 151 premature infants with gestational ages less than 34 weeks were enrolled. According to placental pathology, subjects were divided into CA（ -- ） FV（ -- ） group, CA（ ＋ ） FV（ -- ） group, and CA（＋ ）FV（＋）group. Incidence of diseases and the infection parameters among three groups were compared. Result The incidence of diseases increased with the progress of inflammation,and the incidence rates of pneumonia,respira- tory distress syndreme （RDS）,intracranial hemorrhage, and necrotizing enteroco[itis （NEC） in three groups were signifi- cantly different （P〈0.05）. Prenatal fever,white blood cell count（WBC） of prenatal maternal infection,C reactive protein （CRP） and neonatal calcitonin peptide（PCT）were significantly different （P〈0.05）. With the increasing of the infection in- dex,tissue type chorioamnionitis and funisitis increased gradually,while the difference of the prenatal N% and infection in-dex of preterm infants was not significant （P^0.05）. Conclusion Exposure to chorioamnionitis or funisitis will lead to higher incidence of organ damage in preterm infants of gestational age less than 34 weeks. Also, the incidence rates of pneu- monia, RIDS,intracranial hemorrhage,NEC are closely correlated with chorioamnionitis or funisitis. The levels of WBC,C re active protein（CRP） and neonatal calcitonin peptide（PCT）could be an indicator to predict the occurrence of chorioamnionitis or funisitis in preterm infants.