绒毛膜羊膜炎对早产儿脑损伤的影响

Effect of chorioamnionitis on brain injury in preterm infants

摘要:

目的：探讨绒毛膜羊膜炎与早产儿脑损伤的相关性。方法：选取2008年6月至2011年6月出生的早产儿（28~34周）共88例。根据是否存在绒毛膜羊膜炎，分为病例组(41例)和对照组（47例）。所有的病例生后定期行头颅B超检查，生后3~7 d行颅脑弥散加权成像（DWI）检查，且于纠正胎龄 40 周时行颅脑MRI 检查,比较两组脑室周围白质软化（PVL）和脑室周围-脑室内出血（PVH-IVH）的发生情况。结果：病例组PVL的发生率为32%，对照组PVL的发生率为6%,两组比较差异有统计学意义（P<0.05）。而两组PVH-IVH的发生率分别为27%和23%，差异无统计学意义（P＞0.05）。结论：绒毛膜羊膜炎与早产儿脑损伤有一定的关系，可使早产儿PVL的发生率增加，而对PVH-IVH的影响不大。

Abstract:

OBJECTIVE: To explore the association between chorioamnionitis and brain injury in preterm infants. METHODS: A total of 88 preterm infants (28-34 weeks), who were born between June 2008 and June 2011, were divided into a case group (n=41) and a control group (n=47) according to whether or not they had chorioamnionitis. All the infants were examined by brain ultrasonography periodically after birth and underwent brain diffusion weighted imaging (DWI) between 3 and 7 days after birth. The two groups were compared in terms of the incidence of periventricular leukomalacia (PVL) and periventricular and intraventricular hemorrhage (PVH-IVH) by brain magnetic resonance imaging (MRI) at the corrected gestational age of 40 weeks. RESULTS: There was statistical significance in the incidence of PVL between the case and the control groups (32% vs 6%; P0.05). CONCLUSIONS: Chorioamnionitis is associated with brain injury in preterm infants, increasing the incidence of PVL but having little influence over the incidence of PVH-IVH.