CAJ | 학술논문

目的探讨早产儿胃液解脲脲原体(UU)阳性与围生期疾病的关系.方法采用荧光定量聚合酶链反应法检测270例早产儿胃液UU-DNA,分为UU阳性组和UU阴性组,比较2组早产儿围生期疾病的发生率,并分析胃液UU阳性与围生期疾病的相关性.结果 270例早产儿,胃液UU阳性106例(39.26％,106/270例).UU阳性组总胎龄和出生总体质量均低于UU阴性组,差异有统计学意义(t=-4.024、-2.986,P均＜0.05).2组阴道分娩、胎膜早破(PROM)、PROM时间、体外受精-胚胎移植、产前地塞米松治疗比较差异均有统计学意义(P均＜0.01).2组新生儿肺透明膜病(RDS)、胆汁淤积、住院早期机械通气治疗发生率比较差异均有统计学意义(P均＜0.05),而性别、小于胎龄儿、围生期窒息、气管内滴入肺泡表面活性物质(PS)、肺炎、住院天数,吸氧天数、死亡等比较差异均无统计学意义(P均＞0.05).对104例行早产儿视网膜病(ROP)筛查的早产儿、264例常规行脑室内-脑室周围出血(PIVH)筛查的早产儿、住院天数大于28 d的204例早产儿的支气管肺发育不良(BPD)发病率进行统计,2组间差异均无统计学意义(P均＞0.05).2组出生后3h、1d、3d、7d的WBC、中性粒细胞绝对值、出生后3h血浆IgM值比较差异均有统计学意义(P均＜0.05),而14 d、21 d的WBC、中性粒细胞绝对值比较差异均无统计学意义(P均＞0.05).结论早产儿胃液UU阳性与胎龄小,低出生体质量、PROM、体外受精-胚胎移植等有关,与RDS的发生呈负相关,有增加早产儿胆汁淤积的可能.UU胃液阳性并未增加早产儿病死率.
목적 탐토조산인위액해뇨뇨원체(UU)양성여위생기질병적관계.방법 채용형광정량취합매련반응법검측270례조산인위액UU-DNA,분위UU양성조화UU음성조,비교2조조산인위생기질병적발생솔,병분석위액UU양성여위생기질병적상관성.결과 270례조산인,위액UU양성106례(39.26％,106/270례).UU양성조총태령화출생총체질량균저우UU음성조,차이유통계학의의(t=-4.024、-2.986,P균＜0.05).2조음도분면、태막조파(PROM)、PROM시간、체외수정-배태이식、산전지새미송치료비교차이균유통계학의의(P균＜0.01).2조신생인폐투명막병(RDS)、담즙어적、주원조기궤계통기치료발생솔비교차이균유통계학의의(P균＜0.05),이성별、소우태령인、위생기질식、기관내적입폐포표면활성물질(PS)、폐염、주원천수,흡양천수、사망등비교차이균무통계학의의(P균＞0.05).대104례행조산인시망막병(ROP)사사적조산인、264례상규행뇌실내-뇌실주위출혈(PIVH)사사적조산인、주원천수대우28 d적204례조산인적지기관폐발육불량(BPD)발병솔진행통계,2조간차이균무통계학의의(P균＞0.05).2조출생후3h、1d、3d、7d적WBC、중성립세포절대치、출생후3h혈장IgM치비교차이균유통계학의의(P균＜0.05),이14 d、21 d적WBC、중성립세포절대치비교차이균무통계학의의(P균＞0.05).결론 조산인위액UU양성여태령소,저출생체질량、PROM、체외수정-배태이식등유관,여RDS적발생정부상관,유증가조산인담즙어적적가능.UU위액양성병미증가조산인병사솔.
Objective To examine the relationship between Ureaplasma urealyticum (UU) in gastric fluid and perinatal diseases.Methods The gastric fluid samples were obtained from 270 preterm infants and tested for UU DNA,using a multiplex-polymerase chain reaction (PCR) method.The infants were divided into UU positive and negative group and perinatal factors or diseases were compared between 2 groups.Results UU-DNA were detected in 106 of the 270 infants (39.26％).The gestational age and birth weight were lower in UU positive group than in UU negative group and there were significant differences between 2 groups (t =-4.024,-2.986,all P ＜ 0.05).Compared with 2 groups,the rates of maternal vaginal delivery,in vitro fertiliazation,antenatal dexmethasone therapy,neonatal respiratory distress syndrome (RDS),mechanical ventilation and neonatal cholestasis,and the rates and dutation of premature rupture of membrane (PROM) were significant differences (all P ＜ 0.05).There were no significant differences between 2 groups in the other factors including sex,small for gestational age infant,neonatal asphyxia,administration of pulmonary surfactant to newborn,congenital pneumonia,total duration of oxygen supplementation and mortality (all P ＞ 0.05).There were no significant differences between 2 groups which had routine screenings in retinopathy of prematurity (ROP) for the 106 premature babies and periventricular-intraventricular hemorrhage(PIVH) for the 264 premature babies and bronchopulmonary dysplasia (BPD) for the 204 premature babies that were hospitalized more than 28 days (all P ＞ 0.05).Leukocyte count and neutrophilic granulocyte count at the third hour,on day 1,day 3,day 7 and plasma IgM at the third hour were higher in UU positive group than in negative group(all P ＜0.05).There were no significant differences of the mortality between 2 groups (all P ＞ 0.05).Conclusions The presence of UU in gastric fluid before 37 weeks is associated with low gestational age,low birth weight,maternal vaginal delivery,in vitro fertiliazation,premature rupture of membranes,and decreased risk of neonatal respiratory distress syndrome,and increases the tendency of cholestasis,but the presence of UU is not associated with the mortality of premature infants.