陈静 徐发林

[摘要] 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臨床依据。 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。

[关键词] 解脲脲原体;呼吸系统;并发症;早产胎龄;检测

[Abstract] 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.

[Key words] Ureaplasma urealyticum; Respiratory system; Complication; Premature gestational age; Detection

早產儿指妊娠不足37周的活产新生儿，其因器官发育不完全及免疫功能低下，出生后对外界抵抗力低于正常新生儿，存活率较低[1]。目前宫内感染被认为可能是导致早产的主要原因之一[2]。解脲脲原体（Ureaplasma urealyticum，UU）主要寄生于人体泌尿生殖道，孕妇感染UU可引起宫内感染，从而导致胎膜早破（Premature rupture of membranes，PROM）、绒毛膜羊膜炎及早产等;UU感染可通过母婴垂直传递，新生儿感染后可导致先天性肺炎、支气管肺发育不良（Bronchopulmonary dysplasia，BPD）等。近年来，关于UU感染的研究报道日益增多，其所引起的泌尿生殖道感染也正在逐步受到重视。杨耀锋等[3]指出UU感染与早产儿支气管肺发育不良密切相关，是早产儿BPD产生的重要原因之一。但目前关于UU感染对早产儿呼吸系统的影响多集中在某一具体胎龄，对于UU感染对不同胎龄早产儿呼吸系统的研究较少。因此，本重点研究UU感染对胎龄<32周中不同胎龄的早产儿呼吸系统的影响，进一步分析UU感染对不同胎龄早产儿呼吸系统的影响，以期为临床针对不同胎龄早产儿UU感染造成呼吸系统疾病的治疗提供理论依据，现报道如下。

1 资料与方法

1.1 一般资料

选取2018年11月至2019年11月期间我院早产儿80例（胎龄均<32周），无窒息史和畸形，其中25周<胎龄≤26周18例，26周<胎龄≤28周17例，28周<胎龄≤30周28例，30周<胎龄<32周17例。详细记录患儿的临床资料，如母亲的情况、患儿的情况、入院后的检查和治疗过程等，并由患儿母亲自愿签订知情同意书，以协助本研究的进行。所有患儿的临床资料均完整。本研究方案已通过本院医学伦理委员会审核。

1.2 纳入与排除标准

1.2.1 纳入标准  BPD的诊断标准参……