The Study On Pulmonary Injury And Common Diseases Of Premature Infants Exposed To Chorioamnionitis And Funisitis

Objective :To investigate the correlation between chorioamnionitis or funisitis and lung injury whose gestation ages of less than 34 weeks when they exposed to chorioamnionitis or funisitis.To investigate the relationship between chorioamnionitis or funisitis and common diseases in preterm infants of gestational age<34 weeks.Methods:one hundred and fifty-one singleton infants who gestation ages of less than 34 weeks were enrolled.According to placental pathology were divided into HCA-FV-group,HCA+ FV-group,HCA+FV+ group,then the patients with chorioamnionitis positive were divided into 0-3 groups and 0-3 grades according to the Redline staging standard and divided into 4 groups.So we compared compared the difference of the time of respiratory support,respiratory oxygenation index(PaO2/Fi O2、a/A、A-aDO2).Moreover,68 infants were given the tidal breath pulmonary function test at 40 weeks of the corrected gestational age,then we compared the difference between them.And then we compared the difference of incidence of diseases.Then we compared the differences in the infection parameters of each group.Result:1.The respiratory support time increased gradually with the degree of inflammatory invasion and the degree of inflammation in each group.After adjusted gestational age,noninvasive ventilation time[0.0(0.0-0.0)VS 0.0(0.0-0.0)VS0.0(0.0-58.5)VS 1.0(0.0-130.3)] 、 invasive ventilation time [(0.0(0.0-0.0)VS0.0(0.0-0.0)VS 0.0(0.0-0.0)VS 0.0(0.0-2.3)],were no statistically significant difference.The total ventilation time[0.0(0.0-0.0)VS 0.0(0.0-5.25)VS 0.0(0.0-64.8)VS 0.0(0.0-114.5)] 、 Oxygen inhalation time [0.0(0.0-8.5)VS 0.0(0.0-57.3)VS13.5(0.0-131.8)VS 97.0(0.0-284.8)] were statistically significant(P < 0.05).2.In all groups,PaO2 [(81.6±17.8)VS(85.7±32.1)VS(92.8±43.8)VS(96.6±37.5)] 、PaO2/Fi O2 [385.7(296.3-439.6)VS 376.2(289.6-445.2)VS 373.8(263.6-497.6)VS363.6(233.1-464.3)] 、a/A [0.8(0.7-0.9)VS 0.9(0.8-1.1)VS 0.7(0.4-0.9)VS 0.8(0.5-1.0)]and A-aDO2 [18.0(6.9-33.6)VS 5.4(-4.8-15.6)VS 30.0(7.7-80.3)VS 28.0(0.5-75.8)]were no statistically significant difference,and FiO2 [21.0(21.0-22.0)VS21.0(21.0-23.0)VS 22.0(21.0-30.0)VS 23.0(21.0-30.0)] was statistically significant(P<0.05).3.Compared pulmonary function,in addition to the respiratory frequency,VPEF/TE[(29.79±11.50)VS(27.36±11.01)VS(926.01±13.27)] 、 VPEF/VE[(34.20±8.91)VS(31.90±9.20)VS(31.67±9.55)] 、 VPEF[(0.18±0.04)VS(0.18±0.06)VS(0.16±0.07)]、TPEF[(18.84±22.69)VS(8.17±3.10)VS(6.23±2.73)] and so on gradually decreased with the degree of inflammation progress,but there was no statistically significant difference(P>0.05).4.Comparison of diaeases:the incidence of all kinds of diseases increased with the progress of inflammation,and the difference of incidence of pneumonia[7.0(21.2)VS27.0(44.3)VS 28.0(48.1)]、 RDS[0.0(0.0)VS 1.0(1.6)VS 7(12.3)]、Intracranial hemorrhage [0.0(0.0)VS 2.0(3.3)VS 7(12.3)] and NEC [0.0(0.0)VS 1.0(1.6)VS8(14.0)] in HCA +FV+group and HCA-FV-group,HCA+FV-was statistically significant(P<0.05).5.Comparison of infection index:prenatal fever [0(0.0)VS 6(9.8)VS 8(57.0)]、the number of white blood cell index(WBC)[(10.6±2.9)VS(12.8±3.8)VS(13.5±3.4)] of prenatal maternal infection,C reactive protein(CRP)[0.8(0.8-3.4)VS 7.5(3.2-22.9)VS13.2(3.2-45.2)] and neonatal calcitonin peptide(PCT [(3.0±5.8)VS(4.1±5.5)VS(8.7±14.7)]were statistically significant(P<0.05),and with the increasing of the infection index,tissue type chorioamnionitis and funisitis increased gradually,while there were no significant(P>0.05)of the prenatal N% and infection index of preterm infants.Conclusions:1.Chorioamnionitis or funisitis may be closely related to the lung injury in preterm infants whose gestation ages of less than 34 weeks when they exposed to them.2.The more serious of the degree of placental inflammation,the faster the rate of progression,the risk of lung injury were higher in preterm premature infants in <34 weeks,then the respiratory support time were maybe longer.3.Chorioamnionitis or funisitis may not be affected the Tidal Pulmonary function whose gestation ages of less than 34 weeks when they exposed to them.4.After exposed the chorioamnionitis or funisitis,the incidence of diseases gradually increased in preterm infants of gestational age < 34 weeks,and the incidence of pneumonia 、 RDS 、 Intracranial hemorrhage 、 NEC was closely correlated with chorioamnionitis or funisitis.5.The level of C reactive protein(CRP)and neonatal calcitonin peptide(PCT)can be used as an indicator to predict the occurrence of chorioamnionitis or funisitis.