摘要
目的分析新生儿高胆红素血症(NHB)的相关影响因素,及新生儿NHB与肠道菌群特征的关系。方法选取2019年2月至2020年12月日照市岚山区人民医院收治142例NHB新生儿作为观察组,男68例,女74例,日龄1~7(4.26±1.61)d,出生体质量2.24~4.01(3.02±0.52)kg。同期选取147例健康新生儿作为对照组,男75例,女72例,日龄1~7(4.25±1.57)d,出生体质量2.30~4.12(3.16±0.46)kg。测量前额和胸部胆红素、血清总胆红素,检测新生儿粪便中菌群分布情况。采用χ^(2)检验、t检验,单因素和多因素logistic回归分析NHB的独立危险因素。结果观察组和对照组出生体质量、胎龄、围生期感染、胎儿窘迫、剖宫产、胎膜早破、母乳缺乏、妊娠期高血压、妊娠期糖尿病方面比较,差异均有统计学意义(均P<0.05)。观察组双歧杆菌为(7.96±0.58)、乳杆菌为(8.05±0.71)、大肠埃希菌为(7.32±0.83),对照组分别为(9.02±0.61)、(8.77±0.76)、(6.66±0.62),观察组新生儿粪便中双歧杆菌、乳杆菌数量较少(t=15.129、8.316,均P<0.001),大肠埃希菌数量较多(t=7.676,P<0.001)。剖宫产、胎膜早破、胎儿窘迫、围生期感染、双歧杆菌数量、乳杆菌数量、大肠埃希菌数量是新生儿NHB发生的独立危险因素。结论新生儿NHB与多种因素密切相关,剖宫产、胎膜早破、胎儿窘迫、围生期感染、双歧杆菌数量减少、乳杆菌数量减少、大肠埃希菌数量增加均可增加NHB的发病风险。
Objective To analyze the related influencing factors of neonatal hyperbilirubinemia(NHB)and the relationship between neonatal NHB and the characteristics of intestinal flora.Methods From February 2019 to December 2020,142 NHB neonates were selected as an observation group,including 68 boys and 74 girls who were 1-7(4.26±1.61)days old and whose birth weight was 2.24-4.01(3.02±0.52)kg;and 147 healthy neonates during the same period were selected as a control group,including 75 boys and 72 girls who were 1-7(4.25±1.57)days old and whose birth weight was 2.30-4.12(3.16±0.46)kg.The levels of forehead and chest bilirubin and serum total bilirubin were measured.The distribution of the bacterial flora in the feces of the two groups was detected.χ^(2) and t tests were applied.Univariate and multivariate logistic regression analyses were used to analyzed the independent risk factor of NHB.Results There were statistical differences in birth weight,gestational age,peripartum infection,fetal distress,cesarean section,premature rupture of fetal membrane,lack of breast milk,gestational hypertension,and gestational diabetes between these two groups(P<0.05).The numbers of bifidobacteria,lactobacilli,and Escherichia coli were(7.96±0.58),(8.05±0.71),and(7.32±0.83)in the observation group,and were(9.02±0.61),(8.77±0.76),and(6.66±0.62)in the control group,with statistical differences(t=15.129,8.316,and 7.676;all P<0.001).Cesarean section,premature rupture of fetal membrane,peripartum infection,and the numbers of bifidobacteria,lactobacilli,and Escherichia coli were independent risk factors for the occurrence of neonatal NHB.Conclusions Neonatal NHB is closely related to many factors.Cesarean section,premature rupture of fetal membrane,fetal distress,peripartum infection,the decrease of bifidobacteria and lactobacilli,and the increase of Escherichia coli all can increase the risk of NHB.
作者
赵生莹
于锡洋
李艳
陈卫珍
董书兰
Zhao Shengying;Yu Xiyang;Li Yan;Chen Weizhen;Dong Shulan(Department of Neonatology,Lanshan District People's Hospital,Rizhao 276800,China)
出处
《国际医药卫生导报》
2022年第3期380-384,共5页
International Medicine and Health Guidance News
