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目的:探讨极低出生体重儿痰真菌培养结果,并分析其影响因素。方法:回顾性分析宁波市妇女儿童医院2011年5月~2013年5月收治的85例痰液培养结果为阳性的极低出生体重合并肺炎新生儿的临床资料,并根据痰液培养结果将患儿分为细菌感染组(30例)、真菌感染组(25例)及混合感染组(30例),对比分析3组痰真菌培养结果及影响因素。结果:真菌组及混合组患儿嗜酸性粒细胞比例显著高于细菌组(P<0.05),而巨噬细胞比例、白细胞总数及中性粒细胞总数显著低于细菌组(P<0.05)。单因素分析显示母体产前应用激素、应用三联抗生素、机械通气时间、母体贫血、母乳喂养、胎龄及应用碳青霉烯类药物均可影响极低出生体重儿痰真菌培养结果。Logistic多因素回归分析显示产前应用激素、胎龄及应用碳青霉烯类药物是影响痰真菌培养结果的独立危险因素。结论:极低出生体重儿中普遍存在痰真菌生长,产前应用激素、胎龄及应用碳青霉烯类药物可作为极低出生体重儿痰真菌生长的独立危险因素,测定上述指标可有效预测极低出生体重儿痰真菌生长情况。
Objective: To investigate the results of sputum fungal culture of very low birth weight infants and to analyze the influencing factors. Methods: A retrospective analysis of Ningbo Women and Children’s Hospital from May 2011 to May 2013 admitted to 85 cases of sputum culture was positive for very low birth weight pneumonia neonates with clinical data, and according to the results of sputum culture will be Children were divided into bacterial infection group (30 cases), fungal infection group (25 cases) and mixed infection group (30 cases). The sputum fungal culture results and influencing factors were compared among the three groups. Results: The proportion of eosinophils in fungal group and mixed group was significantly higher than that in bacterial group (P <0.05). The percentage of macrophages, total leukocytes and neutrophils were significantly lower than those in bacterial group (P <0.05). Univariate analysis showed that maternal prenatal application of hormones, application of triple antibiotics, mechanical ventilation time, maternal anemia, breastfeeding, gestational age and application of carbapenems could affect sputum fungal culture results for very low birth weight infants. Logistic multivariate regression analysis showed that prenatal steroid use, gestational age and the use of carbapenems were independent risk factors for sputum fungal culture. CONCLUSION: Phlegm fungus growth, prenatal steroid use, gestational age and carbapenems prevalent in very low birth weight children may be used as independent risk factors for the growth of sputum in very low birth weight infants. The above indexes can be effectively predicted Very low birth weight sputum fungal growth.