解脲支原体感染与早产儿呼吸系统疾病的相关性

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。

Relativity of Ureaplasma urealyticum in lung disease of prematurity

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: Urealyticum 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 infants, it predisposes to development of CLD, independently of gestational age.