儿童反复呼吸道感染的危险因素分析

doi:10.19983/j.issn.2096-8493.20220060

摘要/Abstract

摘要：

目的: 分析儿童反复呼吸道感染的危险因素。方法:收集2018年6—10月于河北省儿童医院住院治疗的2194例儿童呼吸道感染患者的人口学特征、既往史、疾病相关数据。2194例呼吸道感染患儿中诊断为反复呼吸道感染的患儿作为观察组(275例),其余偶发或不符合反复感染定义和诊断标准的患儿作为对照组(1919例)。分析儿童反复呼吸道感染的流行病学特征,运用二元和多因素logistic回归分析影响患儿反复呼吸道感染的危险因素。结果:2194例呼吸道感染患儿中呼吸道病原体检出535例,阳性率为24.4%。其中,呼吸道合胞病毒166例,阳性率为7.6%;甲型流感病毒124例,阳性率为5.7%;副流感病毒98例,阳性率为4.5%;、乙型流感病毒78例,阳性率为3.6%;腺病毒42例,阳性率为1.9%;支原体27例,阳性率为1.2%。多因素logistic回归分析结果显示,接受日托(OR=4.181,95%CI:3.529~6.040)、被动烟草暴露(OR=5.027,95%CI:4.393~9.308)、家中潮湿(OR=2.004,95%CI:1.333~4.207)、与0~5岁儿童共用一间卧室(OR=1.916,95%CI:1.249~2.404)、有过敏史(OR=3.165,95%CI:2.359~4.421)是儿童反复呼吸道感染发生的危险因素。结论:接受日托、共用一间卧室增加了空间聚集性,从而增加了儿童反复呼吸道感染的发生风险;被动烟草暴露、居住环境潮湿及过敏史均通过损害呼吸道的防御机制增加了病原体定植及感染的风险。

关键词: 呼吸道感染, 危险因素, 回归分析

Abstract:

Objective: To analyze the risk factors of recurrent respiratory tract infections (RRI) in children. Methods: This study collected demographic characteristics, previous history and disease-related data of 2194 children with respiratory tract infections hospitalized from June to October 2018 in Childrens Hospital of Hebei Province. Among the 2194 children with respiratory tract infection, the children diagnosed with RRI were taken as the observation group (275 cases), and the other children who occasionally or did not meet the definition and diagnostic criteria of recurrent infection were taken as the control group (1919 cases). The epidemiological characteristics of RRIs in children were analyzed, and their risk factors were analyzed with binary and multivariable logistic regression. Results: Within 2194 child patients with respiratory tract infections, 535 cases (24.4%) were detected with respiratory pathogens, including 166 (7.6%) respiratory syncytial virus cases, 124 (5.7%) influenza virus A cases, 98 (4.5%) parainfluenza cases, 78 (3.6%) influenza virus B cases, 42 (1.9%) adenovirus cases and 27 (1.2%) mycoplasma cases. Multivariable logistic regression showed that taking day care service (OR=4.181, 95%CI:3.529-6.040), passive tobacco exposure (OR=5.027, 95%CI:4.393-9.308), humid at home (OR=2.004, 95%CI:1.333-4.207), sharing a bedroom with other children aged 0-5 (OR=1.916, 95%CI:1.249-2.404), history of allergies (OR=3.165, 95%CI:2.359-4.421) were risk factors of RRI in children. Conclusion: Taking daycare service and sharing bedroom increased spatial aggregation thus increased the risk of RRIs. Passive tobacco exposure, humid living environment and history of allergies all increased the risk of pathogen colonization and infection by damaging the defense mechanism of the respiratory tract.

Key words: Respiratory tract infection, Risk factors, Regression analysis

中图分类号:

R725.6

辛超君, 曹利静, 吕丽格. 儿童反复呼吸道感染的危险因素分析[J]. 结核与肺部疾病杂志, 2022, 3(4): 300-304. doi: 10.19983/j.issn.2096-8493.20220060

Xin Chaojun, Cao lijing, Lyu Lige. Analysis of risk factors of recurrent respiratory tract infections in children[J]. Journal of Tuberculosis and Lung Disease, 2022, 3(4): 300-304. doi: 10.19983/j.issn.2096-8493.20220060

图/表 3

表1

表2

表3

儿童反复呼吸道感染的多因素logistic回归分析结果

变量	β值	s $x ¯$ 值	Wald χ²值	P值	OR值	95%CI
日托	2.154	0.119	9.540	<0.001	4.181	3.529~6.040
被动烟草暴露	1.673	0.140	12.924	<0.001	5.027	4.393~9.308
居住环境潮湿	0.100	0.167	5.219	0.037	2.004	1.333~4.207
与0~5岁儿童共用一间卧室	1.239	0.124	0.942	0.016	1.916	1.249~2.404
有过敏史	0.271	0.082	46.287	0.010	3.165	2.359~4.421

表3

参考文献 16

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变量	观察组(275例)	对照组(1919例)	χ²值	P值
性别			45.321	0.000
男性	183(66.5)	861(44.9)
女性	92(33.5)	1058(55.1)
体质量指数			5.599	0.018
≥28	87(31.6)	479(25.0)
<28	188(68.4)	1440(75.0)
日托
是	233(84.7)	1420(74.0)	14.908	0.000
否	42(15.3)	499(26.0)
被动烟草暴露			4.253	0.039
是	88(32.0)	501(26.1)
否	187(68.0)	1418(73.9)
贫血			5.226	0.022
是	22(8.0)	91(4.7)
否	253(92.0)	1828(95.3)
居住环境潮湿			4.740	0.029
是	12(4.4)	263(13.7)
否	263(95.6)	1656(86.3)
与0~5岁儿童共用卧室			4.338	0.037
是	82(29.8)	461(24.0)
否	193(70.2)	1458(76.0)
呼吸窘迫综合征病史			4.182	0.041
有	11(4.0)	39(2.0)
无	264(96.0)	1880(98.0)
过敏史			4.696	0.030
有	16(5.8)	62(3.2)
无	259(94.2)	1857(96.8)
扁桃体炎及中耳炎等感染性疾病病史
有	35(12.7)	171(8.9)	4.118	0.042
无	240(87.3)	1748(91.1)

变量	赋值	变量	赋值
日托	是=1,否=0	过敏史	有=1,无=0
被动烟草暴露	是=1,否=0	贫血	是=1,否=0
居住环境潮湿	是=1,否=0	呼吸窘迫综合征病史	是=1,无=0
与0~5岁儿童共用一间卧室	是=1,否=0	扁桃体炎及中耳炎等感染性疾病病史	有=1,无=0
性别	女=1,男=0	肥胖(体质量指数≥28)	有=1,否=0