胎龄＜32周早产儿坏死性小肠结肠炎与早产儿脑病相关性研究

摘要

目的 探讨胎龄＜ 32周早产儿坏死性小肠结肠炎(necrotizing enterocolitis,NEC)与早产儿脑病(encephalopathy of prematurity,EOP)的相关性.方法 回顾性配对研究,选取2009-2014年本院新生儿科收治的胎龄＜ 32周并在校正胎龄足月或近足月时完成头颅磁共振成像(magnetic resonance imaging,MRI)检查的早产儿.将罹患NEC的早产儿纳入NEC组;根据胎龄、出生体重1∶2配对,选取非NEC早产儿为对照组.采用x2检验分析两组早产儿发生EOP的情况及影像学特点.结果 共纳入早产儿312例,其中NEC组104例,对照组208例.NEC组EOP发生率高于对照组(27.9％比17.3％),差异有统计学意义(P=0.030).两组早产儿头颅MRI检查结果以非囊性EOP为主,且NEC组非囊性EOP比例高于对照组(89.7％比63.9％),差异有统计学意义(P=0.017).结论 胎龄＜32周早产儿NEC与EOP的发生可能具有一定相关性,头颅MRI影像学表现以非囊性损伤为主.%Objective To study the correlation of necrotizing enterocolitis (NEC) and encephalopathy of prematurity (EOP) in premature infants with gestational age (GA) ＜ 32 weeks.Method From January 2009 to December 2014,clinical data of preterm infants (GA ＜ 32 weeks) admitted to department of neonatology of Children's Hospital of Fudan University and received brain magnetic resonance imaging (MRI) at corrected GA of full term or near full term were collected.NEC patients were assigned into the NEC group.At the same time,patients with similar GA and birth weight without NEC were assigned into the control group.The incidence and MRI characteristics of EOP were studied using Chi-square method.Result A total of312 preterm infants were included in our study,104 in the NEC group,and 208 in the control group.The incidence of EOP in the NEC group was higher than the control group (27.9％ vs.17.3％).The difference between the two groups were statistically significant (P =0.030).The incidence of non-cystic EOP in the NEC group was significantly higher than the control group (89.7％ vs.63.9％,P =0.017).Conclusion NEC and EOP may be correlated in preterm infants with GA ＜32 weeks.Most of EOP were non-cystic injury.