ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2019, Vol. 11 ›› Issue (3): 244-247.doi: 10.3969/j.issn.1674-3865.2019.03.018

• 临床研究 • 上一篇    下一篇

晚发型B族链球菌脓毒症患儿临床特征及预后情况

连喜院，雷世鑫，李宏科，郭会萍   

  1. 744000 甘肃 平凉，甘肃医学院附属医院新生儿科（连喜院，郭会萍），检验科（李宏科）；甘肃医学院病原生物学教研室（雷世鑫）
  • 出版日期:2019-06-25 发布日期:2019-07-04
  • 通讯作者: 雷世鑫，E-mail：plleishixin@163.com
  • 作者简介:连喜院（1974-），男，主任医师。研究方向:新生儿疾病的诊治
  • 基金资助:
    2018年甘肃省高等学校科研项目（2018A-147）

Clinical features and prognosis of late-onset GBS pyemia

LIAN Xiyuan，LEI Shixin，LI Hongke，GUO Huiping   

  1. Neonatal Department, the Affiliated Hospital of Gansu Medical College, Pingliang 744000,China
  • Online:2019-06-25 Published:2019-07-04

PDF (PC)

95

摘要： 目的
观察晚发型B族链球菌（GBS）脓毒症患儿的临床特点及预后，分析影响患儿预后的因素。
方法
选择2014年6月至2015年10月甘肃医学院附属医院收治的GBS脓毒症患儿102例为研究对象，早发型48例和晚发型54例。两组患儿临床表现和实验室指标的差异，比较两组患儿并发症发生率和预后情况，分析影响患儿预后的因素。
结果
晚发型患儿发热或低体温、气促、抽搐、呼吸暂停、黄疸、肺炎发生率显著高于早发型患儿，差异有统计学意义（P<0.05）。晚发型组白细胞计数、C反应蛋白、白细胞介素6、肿瘤坏死因子α水平显著高于早发型组，血小板计数显著低于早发型组，差异有统计学意义（P<0.05）。晚发型组化脓性脑膜炎、新生儿坏死性小肠结肠炎、多器官功能衰竭、感染性休克、弥散性血管内凝血发生率显著高于早发型组，差异有统计学意义（P<0.05）。晚发型组治愈率为46.3%（25/54），显著低于早发型组87.5%（42/48），差异有统计学意义（P<0.05）。晚发型组死亡率为31.5%（17/54），显著高于早发型组8.3%（4/48），差异有统计学意义（P<0.05）。GBS类型是导致患儿死亡的危险因素（P<0.05）。
结论
晚发型GBS脓毒症患儿临床表现较严重，死亡率较高，预后差。

关键词: 脓毒症, 细胞因子, GBS, 并发症, 儿童

Abstract: Objective
To observe the clinical characteristics and prognosis of children with late-onset GBS pyemia， and analyze the factors influencing the prognosis of patients.
Methods
A total of 102 children with GBS pyemia treated in our hospital from June 2014 to October 2017 were selected as the research subjects; according to the type of disease, they divided into early-onset group(48 cases) and late-onset group(54 cases). Observe the difference between the two groups of children in the clinical manifestations and laboratory indexes. Compare the incidence of complications and prognosis between the two groups, and analyze the factors influencing the prognosis of patients.
Results
The incidence rate of fever or hypothermia, shortness of breath, convulsions, apnea, jaundice and pneumonia in late-onset group was  significantly higher than that in the early-onset group, the difference having statistical significance (P<0.05). The Index of WBC, CRP, IL-6 and TNF-αlevel in late onset group were significantly higher than those in the early-onset group, while PLT was lower, the difference being statistically significant(P<0.05). The complication rate of purulent meningitis, NEC, MOF septic shock and DIC in late-onset group was significantly higher than in the early-onset group, the difference being statistically significant(P<0.05). The cure rate of late-onset group(46.3%,25/54) was significantly lower than that in the early-onset group(87.5%,42/48)(P<0.05)；mortality rate was significantly higher in late-onset group(31.5%,17/54) than in the early-onset group(8.3%,4/48)(P<0.05); GBS was the risk factor of the death of children(P<0.05).
Conclusion
The clinical manifestations of late-onset GBS pyemia is serious, with high mortality and poor prognosis.

Key words: Pyemia, CytokineGBS, Complication