解脲脲原体感染对胎龄<32周早产儿呼吸系统的影响

Impacts of ureaplasma urealyticum infection on respiratory system of premature infants with gestational age less than 32 weeks

目的探讨解脲脲原体(UU)感染对胎龄<32周早产儿呼吸系统的影响,以期为降低胎龄<32周早产儿感染率提供临床依据。方法选取2018年11月至2019年11月我院早产儿80例(胎龄均<32周),将其分为UU感染组与UU非感染组,取早产儿鼻咽部分泌物并采用荧光定量PCR技术进行UU检测,比较不同胎龄UU感染组中患儿有创呼吸机使用时间、支气管肺发育不良(BPD)发生率的差异。结果UU阳性检出率,PCR法阳性率为33.75%,培养法阳性率为30.0%,差异无统计学意义(P>0.05)。胎龄在25~26周的早产儿UU感染率,PCR法为61.11%(11/18),培养法为55.56%(10/18);26^(+1)~28周的早产儿UU感染率为35.29%(6/17);28^(+1)~30周的早产儿UU感染率,PCR法为25.0%(7/28),培养法为21.43%(6/28);30^(+1)~32周的早产儿UU感染率,PCR法为17.65%(3/17),培养法为11.76%(2/17)。早产儿胎龄越小,UU感染率越高,各组间比较差异无统计学意义(P>0.05)。呼吸系统发病率显示,早产儿胎龄与机械通气时间越长和支气管肺发育不良呈明显负相关,PROM:R=-0.994;BPD:R=-0.951,差异均有统计学意义(P<0.05)。结果表明BPD发病率越高,有创呼吸机应用时间越长。结论UU感染与早产胎龄有一定关系,UU感染对早产儿呼吸系统有一定影响,在产前保健中应加强孕妇UU检测和治疗。

Objective To explore the impacts of ureaplasma urealyticum(UU)infection on respiratory system of premature infants with gestational age less than 32 weeks,so as to provide clinical basis for reducing the infection rate of premature infants with gestational age less than 32 weeks.Methods A total of 80 premature infants(all gestational ages were less than 32 weeks)admitted to our hospital from November 2018 to November 2019 were selected and divided into the UU infection group(case)and the UU non-infection group(case).Nasopharyngeal secretions of premature infants were collected and detected for UU using fluorescent quantitative PCR technology,and the use time of invasive ventilator and the difference in the incidence of bronchopulmonary dysplasia(BPD)among children within the UU infection group for different gestational ages were compared.Results The comparison of the positive detection rate of UU between,the positive rate of PCR method was 33.75%,and the positive rate of culture method was 30.00%,with no statistically significant difference(P>0.05).The infection rate of UU in premature infants with gestational age from 25 to 26 weeks was 61.11%(11/18)by PCR method and 55.56%(10/18)by culture method.The infection rate of UU in premature infants with gestational age from 26^(+1) to 28 weeks was 35.29%(6/17).The infection rate of UU in premature infants with gestational age from 28^(+1) to 30 weeks was 25.00%(7/28)by PCR method and 21.43%(6/28)by culture method.The infection rate of UU in premature infants with gestational age from 30^(+1) to 32 weeks was 17.65%(3/17)by PCR method and 11.76%(2/17)by culture method.The smaller the gestational age was,the higher the UU infection rate was,and the difference was not statistically significant among groups.Comparison of respiratory system morbidity showed a significant negative correlation between gestational age and longer duration of mechanical ventilation and bronchopulmonary dysplasia in premature infants,In terms of PROM,R=-0.994.In terms of BPD,R=-0.951.And the differences were statistically significant.The results showed that the higher incidence of BPD was,the longer the application time of invasive ventilator was.Conclusion UU infection has a certain correlation with premature gestational age and has a certain impact on the respiratory system of premature infants.Therefore,the detection and treatment of UU in pregnant women should be strengthened in prenatal nursing.