不同分期组织学绒毛膜羊膜炎与胎龄小于32周早产儿呼吸窘迫综合征关系的研究

Association of different stages of histological chorioamnionitis with respiratory distress syndrome in preterm infants with a gestational age of < 32 weeks

摘要:

目的 探讨不同分期组织学绒毛膜羊膜炎（HCA）与早产儿呼吸窘迫综合征（RDS）发生率及不同分期HCA与RDS严重程度的关系。方法 收集2018年1月至2020年6月于青岛大学附属青岛妇女儿童医院NICU治疗的患儿及其孕母资料，根据是否发生HCA及分期情况分为对照组（109例）、HCA早期组（126例）、HCA中期组（105例）、HCA晚期组（36例）。对各组患儿胎龄、出生体重、性别、母亲年龄、胎盘早剥、母亲产前使用抗生素等情况及早产儿RDS的发生率进行比较，并将不同分期的HCA与不同级别的RDS进行相关性分析。结果 HCA早期组胎盘早剥发生率低于对照组和HCA晚期组（P < 0.05），HCA早期组母亲产前抗生素使用率高于对照组和HCA晚期组（P < 0.05），HCA早期组RDS发生率低于对照组（P < 0.05）。多因素logistic回归分析结果显示，早期、中期及晚期HCA均是RDS的保护因素（P < 0.05）。Spearman秩相关检验显示早产儿RDS的严重程度与HCA的分期无相关性（P > 0.05）。结论 早期、中期及晚期HCA均可降低早产儿RDS的发生率。HCA分期与早产儿发生RDS严重程度可能没有相关性，但仍需进一步研究验证。

Abstract:

Objective To study the association of different stages of histological chorioamnionitis (HCA) with the incidence rate and severity of respiratory distress syndrome (RDS) in preterm infants. Methods Related data were collected from the infants and their mothers who were treated in the Neonatal Intensive Care Unit of Qingdao Women and Children's Hospital, Qingdao University, from January 2018 to June 2020. According to the presence or absence of HCA and its stage, the infants were divided into four groups: control (n=109), early-stage HCA (n=126), middle-stage HCA (n=105), and late-stage HCA (n=36). The four groups were compared in terms of gestational age, birth weight, sex, maternal age, placental abruption, prenatal use of antibiotics, and incidence rate of RDS. The correlation between HCA stage and RDS severity was analyzed. Results Compared with the control and late-stage HCA groups, the early-stage HCA group had a significantly lower incidence rate of placental abruption and a significantly higher rate of prenatal use of antibiotics (P < 0.05), and the early-stage HCA group had a significantly lower incidence rate of RDS than the control group (P < 0.05). The multivariate logistic regression analysis showed that early-, middle-, and late-stage HCA were protective factors against RDS (P < 0.05). The Spearman test showed that the severity of RDS in preterm infants was not correlated with the HCA stage (P > 0.05). Conclusions Early-, middle-, and late-stage HCA can reduce the incidence rate of RDS in preterm infants. HCA stage may not be correlated with RDS severity in preterm infants, which needs to be verified by further research.