摘要目的 探讨新生儿感染性疾病与脑损伤的关系. 方法 收集北京大学第一医院新生儿病房2005年11月至2010年8月以感染为主要疾病的1266例新生儿的临床资料,总结脑损伤发生情况,采用Logistic回归模型分析感染所致脑损伤发生的相关因素及重度脑损伤的危险因素.结果 感染性疾病新生儿脑损伤发生率为8.6％(108/1266),其中轻度脑损伤101例(8.0％),重度脑损伤7例(0.6％).重度感染患儿脑损伤发生率为38.7％(29/75),明显高于轻度感染患儿脑损伤的发生率(6.7％,79/1191),差异有统计学意义(x2=92.787,P=0.000).1225例足月儿中存在炎症免疫过程的患儿脑损伤的发生率为13.0％(26/200),明显高于无明显炎症免疫过程者(7.5％,77/1025),差异有统计学意义(x2=6.544,P=0.011).Logistic回归分析显示,重度感染是导致重度脑损伤的独立危险因素(OR=15.750,95％CI:1.756～141.281,P=0.014). 结论 新生儿感染性疾病可导致神经系统损伤,尤其是重度感染或存在炎症免疫过程时发生率更高；感染越重,脑损伤程度越重,尤其是混杂有窒息和低血糖等其他因素时.

abstractsObjective To investigate the correlation between neonatal infectious disease and brain injury. Methods Clinical data of 1266 newborns with infectious diseases were collected from Peking University First Hospital from November 2005 to August 2010.The occurrence of brain injury was summarized.Related factors of brain injury caused by infection and the risk factors for severe brain injury were analyzed by Logistic regression model. Results Among the newborns with neonatal infectious diseases, the incidence of brain injury was 8.6％ (108/1266), including 101 (8.0％)mild cases and seven (0.6％) severe cases. The incidence of brain injury for the newborns with severe infectious diseases was higher than those with mild infectious diseases [38.7％(29/75) vs 6.7％(79/1191),x2=92.787,P=0.000].The incidence of brain injury for the newborns with obvious inflammatory reaction was significantly higher than those without [(13.0％(26/200) vs 7.5％ (77/1025),x2=6.544,P=0.011].Severe infection was independent risk factor for severe brain injury by Logistic regression model analysis (OR =15.750,95％ CI:1.756-141.281,P=0.014). Conclusions Iniectious diseases could cause injury on central nervous system,especially when there are severe infections or inflammatory reactions. The severer the infection,the severer the brain injury,especially when complicated by some factors such as asphyxia and hypoglycemia.