急性哮喘患儿肺部感染的危险因素分析  

Risk factors of pulmonary infections in children with acute asthma

作　　者：闫向真[1] 温慧敏[1] 刘新健[1] 牛芳[1] 叶文艳[1] 

机构地区：[1]中国石油天然气集团公司中心医院儿科,河北廊坊065000

出　　处：《中华医院感染学杂志》2013年第14期3436-3437,3440,共3页Chinese Journal of Nosocomiology

基　　金：中石油中心医院发展指导计划(2008056102)

摘　　要：目的探讨急性哮喘患儿并发肺部感染的危险因素以及病原菌的构成,以期更有效降低急性哮喘患儿的肺部感染率。方法将2007年1月-2012年12月住院治疗的389例急性哮喘并发肺部感染的患儿作为病例组,将同期住院的411例单纯急性哮喘患儿作为对照组,所有患儿入院时均常规进行深部痰培养,对急性哮喘患儿并发肺部感染的危险因素及病原菌的构成进行回顾性分析,急性哮喘患儿肺部感染危险因素的分析采用多因素logistic回归分析。结果平喘药糖皮质激素或氨茶碱应用(OR=2.72;95%CI=1.66～4.47)、滥用抗菌药物(OR=1.35;95%CI=1.05～1.73)、合并鼻炎或鼻息肉或鼻窦炎(OR=3.18;95%CI=1.80～5.62)、革兰阴性菌感染(OR=4.01;95%CI=1.20～13.38)是小儿急性哮喘合并肺部感染的危险因素;两组患儿革兰阴性菌构成比比较,病例组高于对照组,差异有统计学意义(P<0.05),革兰阴性菌是小儿急性哮喘并发肺部感染最常见的致病菌。结论小儿急性哮喘合并肺部感染病情严重、复杂,应用平喘药糖皮质激素或氨茶碱、滥用抗菌药物、合并鼻炎或鼻息肉或鼻窦炎、革兰阴性菌感染是小儿急性哮喘合并肺部感染的危险因素,应尽早明确诊断,实施正确及有针对性的治疗和护理。OBJECTIVE To discuss the risk factors of pulmonary infections in the children with acute asthma and explore the composition of the pathogenic bacteria so as to effectively reduce the incidence of pulmonary infections in the children with acute asthma.METHODS A total of 389 cute asthma children complicated with pulmonary infections,who were treated in the hospital from Jan 2007 to Dec 2012,were chosen as the infection group,while 411 children with simple cute asthma who were hospitalized during the same period were selected as the control group,and the deep sputum culture was performed for all the children on the admission,then the risk factors of the pulmonary infections in the acute asthma children and the composition of the pathogenic bacteria were retrospectively analyzed,finally,multivariate logistic regression analysis was carried out.RESULTS Multivariate logistic regression analysis revealed that corticosteroid or aminophylline（OR=2.72;95%CI=1.66-4.47）,antibiotics abuse（OR=1.35;95%CI=1.05-1.73）,complication with rhinitis or nasal polyps or sinusitis（OR=3.18;95%CI=1.80-5.62）,and the gram-negative bacteria infecitons（OR=4.01;95%CI=1.20-13.38）were the risk factors of the pulmonary infections in the children with acute asthma.As compared with the compsition of the gram-negative bacteria,the infection group was higher than the control group,the difference was statistically significant（P0.05）,the gram-negative bacteria were the most common pathogens causing infections in the children with acute asthma.CONCLUSIONThe condition of the acute asthma children complicated with pulmonary infections is severe and complicated.The corticosteroid or aminophylline,antibiotics abuse,complication with rhinitis or nasal polyps or sinusitis,and gram-negative bacteria infection are the risk factors of the pulmoanry infections in the children with acute asthma.It is neceassary to perform the clear diagnosis in the early stage and carry out the targeted nurisng and treatment.

关 键 词：哮喘急性发作 肺部感染 儿童 危险因素 

分 类 号：R563.1[医药卫生—呼吸系统]