解脲支原体感染新生儿的临床特征分析

Clinical characteristics analysis of newborns with ureaplasma urealyticum

目的分析解脲支原体感染新生儿的临床特征,为临床诊治提供依据。方法回顾性分析柳州市妇幼保健院新生儿科病房2019年6月至2021年6月收治的94例解脲支原体感染新生儿的临床资料,根据胎龄分为早产儿组和足月儿组,对比两组患儿的母亲基本信息、实验室检查结果及合并症,并评估不同大环内酯类药物治疗的有效性及安全性。结果呼吸道解脲支原体发生率为14.95%,多见于早产儿特别是极早产儿。早产儿组以胎膜早破最为常见,足月儿组以产前发热最为常见。两组患儿的血常规结果无显著性差异(P>0.05),早产儿组较足月儿组更易发生病理性黄疸、新生儿肺炎、新生儿呼吸窘迫综合征(NRDS)和支气管肺发育不良(BPD)(χ^(2)=8.002、15.499、12.185、5.406,均P<0.05)。阿奇霉素和红霉素治疗早产儿解脲支原体感染的有效率分别为81.82%和75.00%,不同药物治疗组的住院时间、吸氧时间、有创呼吸机使用时间、生后即插管情况、坏死性小肠结肠炎(NEC)、BPD、早产儿视网膜病变(ROP)、转阴率差异无统计学意义(t/χ^(2)=-0.736、-0.132、1.754、0.509、0.157、0.242、2.070、0.001,均P>0.05)。结论解脲支原体对新生儿及其母亲均有一定影响。采用阿奇霉素或红霉素治疗解脲支原体感染的早产儿,两种药物的疗效无显著性差异。

Objective To analyze the clinical characteristics of newborns infected with ureaplasma urealyticum,providing a basis for clinical diagnosis and treatment.Methods A retrospective analysis of the clinical data of 94 newborns with ureaplasma urealyticum infection admitted to the department of neonatology of Liuzhou Maternity and Child Health Hospital from June 2019 to June 2021 was conducted.They were divided into preterm and term groups according to their gestational age.The basic information of the mothers,laboratory examination results,and complications of the two groups of patients were compared.And the effectiveness and safety of different macrolide antibiotics in the treatment were evaluated.Results The incidence of respiratory tract ureaplasma urealyticum was 14.95%,more common in premature infants,especially extremely preterm infants.Premature infants are most commonly associated with premature rupture of membranes,while term infants are most commonly associated with antenatal fever.There was no significant difference in blood routine results between the two groups of patients(P>0.05).Premature infants are more prone to pathological jaundice,neonatal pneumonia,neonatal respiratory distress syndrome(NRDS),and bronchopulmonary dysplasia(BPD)than term infants(χ^(2)=8.002,15.499,12.185 and 5.406,respectively,all P<0.05).The effective rates of azithromycin and erythromycin for the treatment of preterm infants with ureaplasma urealyticum infection were 81.82%and 75.00%,respectively.There was no significant difference in the hospitalization time,oxygen therapy time,duration of invasive ventilation,postnatal intubation,necrotizing enterocolitis(NEC),BPD,retinopathy of prematurity(ROP),and conversion rate between different drug treatment groups(t/χ^(2)=-0.736,-0.132,1.754,0.509,0.157,0.242,2.070 and 0.001,respectively,all P>0.05).Conclusion Ureaplasma urealyticum has certain effects on newborns and their mothers,and there is no significant difference in efficacy between azithromycin and erythromycin in the treatment of premature infants with ureaplasma urealyticum infection.