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目的分析绒毛膜羊膜炎及脐带炎与早产儿生后常见疾病的相关性。方法选取在本院产科分娩且住新生儿科<34周早产儿151例,根据胎盘病理结果分为绒毛膜羊膜炎(CA)(-)脐带炎(FV)(-)组33例,CA(+)FV(-)组61例,CA(+)FV(+)组57例,收集孕妇及患儿围生期相关资料,比较各组患儿生后常见疾病发生率及各感染指标差异。结果 3组比较,各疾病发生率随炎症进展逐渐增高,且肺炎、呼吸窘迫综合征(RDS)、颅内出血、坏死性小肠结肠炎(NEC)发生率差异有统计学意义(P<0.05)。母亲产前发热、白细胞数、C反应蛋白及新生儿降钙素原各组比较差异有统计学意义(P<0.05),且随感染指标增高,CA及FV发生率随之增高,而产前中性粒细胞百分比及患儿感染指标差异均无统计学意义(P>0.05)。结论绒毛膜羊膜炎、脐带炎暴露时,可导致早产儿生后常见疾病发生率增加,且与肺炎、RDS、NEC发生密切相关。母亲产前C反应蛋白(CRP)及早产儿生后新生儿降钙素原(PCT)水平可作为预测绒毛膜羊膜炎发生的一项指标。
Objective To analyze the correlation between chorioamnionitis and umbilical cord inflammation and common diseases of premature infants. Methods Fifty-one preterm infants (<35 weeks old) with obstetrical birth and neonatal <34 weeks were divided into 33 cases of chorioamnionitis (CA) (-) umbilical corditis (FV) ), 61 cases of FV (-) group and 57 cases of CA (+) FV (+) group. The data of perinatal period were collected from pregnant women and children. The prevalence of common diseases and the difference of each infection index were compared between the two groups. Results Compared with the control group, the incidence of each disease increased gradually with the progress of inflammation, and the incidence of pneumonia, respiratory distress syndrome (RDS), intracranial hemorrhage and necrotizing enterocolitis (NEC) was significantly different (P <0.05). Prenatal fever, white blood cell count, C-reactive protein and neonatal procalcitonin in each group were significantly different (P <0.05). With the increase of infection, the incidence of CA and FV increased, while the prenatal Neutrophil percentage and children infected indicators showed no significant difference (P> 0.05). Conclusions Chorioamnionitis and umbilical cord inflammation can lead to the increase of the incidence of common diseases in premature infants, which is closely related to pneumonia, RDS and NEC. Prenatal C-reactive protein (CRP) and neonatal procalcitonin (PCT) levels in preterm infants may be used as an indicator of chorioamnionitis.