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目的:通过双胎研究探讨遗传因素在新生儿呼吸窘迫综合征(NRDS)发病中的作用。方法:以2010-01-2014-12华中科技大学同济医学院附属同济医院新生儿重症监护室收治的101对双胞胎患儿为研究对象,每对双胞胎中至少有1例患有NRDS。通过产检资料、产科出生记录、胎盘、性别及血型信息来确定卵型,其中单卵双胎40对,异卵双胎61对;比较单卵双胎和异卵双胎患儿NRDS发病率和同患病率的差异。临床资料用计量资料和计数资料描述,计量资料采取非参数检验,计数资料采用χ2检验比较2组资料的差异,所有数据采用Stata 11.0软件包进行分析。结果:单卵双胎组平均胎龄和出生体重分别为(30.94±2.40)周和(1 509±452)g;异卵双胎组分别为(30.86±1.89)周和(1 573±396)g,2组比较差异无统计学意义;单卵双胎组和异卵双胎组胎膜早破时间(定义为≥18h)、母妊娠糖尿病、产前足疗程糖皮质激素使用率、剖宫产率、5min Apgar评分≤8分、性别构成比等指标比较均差异无统计学意义。40对单卵双胎和61对异卵双胎患儿NRDS发病率分别为85%(68/80)和73%(89/122),2组比较差异有统计学意义(χ2=4.050,P<0.05)。单卵双胎组,双胎均发生NRDS的同患病率为70.0%(28/40),而异卵双胎组NRDS同患病率为45.9%(28/61),差异有统计学意义(χ2=5.68,P<0.05)。结论:单卵双胎组患儿NRDS发病率和同患病率均较异卵双胎组高,提示NRDS具有遗传易感性。
Objective: To explore the role of genetic factors in the pathogenesis of neonatal respiratory distress syndrome (NRDS) through twin studies. Methods: A total of 101 pairs of twins admitted to Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2010 to November 2014 were enrolled. At least 1 out of every twins had NRDS. Ovary was confirmed by the information of birth examination, obstetric birth record, placenta, gender and blood group information, including 40 pairs of monozygotic twins and 61 pairs of fraternal twins; comparing the incidence of NRDS in children with monozygotic twins and fraternal twins Differences with the prevalence. The clinical data were described by the measurement data and the count data. The measurement data were tested by non-parametric test. The difference between the two groups of data was compared by χ2 test. All the data were analyzed by Stata 11.0 software package. Results: The mean gestational age and birth weight of the monozygotic twins group were (30.94 ± 2.40) weeks and (1,509 ± 452) g, respectively. The mean twins were (30.86 ± 1.89) weeks and (1 573 ± 396) g, the difference between the two groups was not statistically significant; single-egg twins and fraternal twins premature rupture of membranes time (defined as ≥ 18h), gestational diabetes mellitus, prenatal full-course glucocorticoid use rate, cesarean section Yield, 5min Apgar score ≤ 8 points, sex composition ratio and other indicators were no significant difference. The incidence of NRDS in 40 pairs of monozygotic twins and 61 pairs of fraternal twins was 85% (68/80) and 73% (89/122), respectively, with significant difference between the two groups (χ2 = 4.050, P <0.05). The same prevalence of NRDS in monozygotic twins and twins was 70.0% (28/40), while the prevalence of NRDS in the same-sex twins was 45.9% (28/61), the difference was statistically significant (χ2 = 5.68, P <0.05). Conclusion: The incidence of NRDS and the prevalence of NRDS in children with monozygotic twins are higher than that of the twins, suggesting that NRDS has genetic predisposition.