宫内解脲脲原体和人型支原体感染与自发早产发生的关系及其对早产儿的影响

目的 检测胎龄23～32周早产儿脐带血中解脲脲原体、人型支原体的感染率和脐带血IL-6阳性率,并判断其与胎膜早破以及早产儿预后的相关性.方法 2009年1月-2010年1月于新乡市中心医院出生的187例早产儿和53例足月儿及其母亲入选本实验,利用PCR技术测定脐带血解脲脲原体和人型支原体,利用放射免疫法测定脐带血IL-6;搜集并记录患儿母亲相关医学信息;对入选早产儿进行预后追踪.结果 自发早产儿与非自发早产儿脐带血IL-6阳性率以及解脲脲原体和/或人型支原体检测阳性率比较,差异有统计学意义(P=0.005,P=0.009);胎膜早破与解脲脲原体和/或人型支原体感染相关(P=0.006).解脲脲原体和/或人型支原体感染与早产儿全身炎症反应综合征(SIRS)和支气管肺发育不良(BPD)的发生相关(P=0.017,P=0.031);而与早产儿呼吸窘迫综合征(RDS)无关(P=0.116).结论 解脲脲原体和/或人型支原体感染是自发早产发生的一个重要原因,并影响早产儿的预后.

The presence of Ureaplasma urealyticum and Mycoplasma honinis in umbilical cord and the association with the outcome of premature infant

Objective To evaluate the frequency of the infections with Ureaplasma urealyticum and/or Mycoplasma honinis in preterm 23 to 32 week births and the association with the outcomes of new born. Methods One hundred and eighty-seven mother/premature infant dyads with deliveries between 23 and 32 weeks gestational age. Ueaplasma urealyticum, Mycoplasma honinis and IL-6 were determined by PCR and radioimmunity. Medical information and outcome of newborns were recorded. Results Compared with control group, the incidence of Ureaplasma urealyticum and/or Mycoplasma honinis, IL-6 and preterm premature rupture of the fetalmembranes ( PPROM ) were higher in spontaneous group. The PPROM were more common among infants with a positive Ureaplasma urealyticum and/or Mycoplasma honinis. Infants with positive cord blood Ureaplasma urealyticum and/or Mycoplasma honinis were likely to have neonatal systemic inflammatory response syndrome (SIRS) and bronchopulmonary dysplasia (BPD), but not significantly different for respiratory distress syndrome (RDS). Conclusion Infection with Ureaplasma urealyticum and/or Mycoplasma honinis may play an important role in the causal pathway for spontaneous preterm labor, and impact the outcome of premature infants.