喘息住院婴儿痰液半定量培养细菌数量与临床特征的相关性  

Correlation of bacteria population confirmed by semi-quantitative culture of sputum with clinical features in hospitalized infants with wheezing diseases

作　　者：孙慧明[1] 周卫芳[1] 季伟[1] 严永东[1] 陈正荣[1] 陶云珍[1] 

机构地区：[1]苏州大学附属儿童医院呼吸科,215003

出　　处：《中华实用儿科临床杂志》2014年第22期1711-1716,共6页Chinese Journal of Applied Clinical Pediatrics

基　　金：基金项目：江苏省社会发展项目（BE2012652）;苏州市“科教兴卫”青年科技项目（KJQND2011005）

摘　　要：目的 研究喘息住院婴儿痰液半定量细菌培养数量与临床特征的相关性。方法 收集2010年1月至2011年12月因喘息入住苏州大学附属儿童医院呼吸科且病史资料完整的婴儿957例，采集呼吸道分泌物进行痰液细菌检查，依据痰液半定量培养细菌数量分为0＋、1＋ ～2＋和3＋ ～4＋组，应用预测统计分析软件（PASW）20.0软件对3组患儿临床特征进行分析。结果 1.共有372例患儿痰液细菌培养阳性，占38.87%（372/957例）。痰液细菌0＋组共585例，1＋ ～2＋组225例，3＋ ～4＋组147例；痰液细菌1＋ ～2＋组以流感嗜血杆菌（24.89% ，56/225例）和肺炎链球菌（16.00% ，36/225例）较常见；痰液细菌3＋ ～4＋组以肺炎链球菌（54.42% ，80/147例）和流感嗜血杆菌（8.84% ，13/147例）常见。2.与痰液细菌0＋组相比，痰液细菌3＋ ～4＋组患儿有兄弟姐妹、发绀的比例较高，中性粒细胞比例和 C反应蛋白水平较高、淋巴细胞比例较低；痰液细菌1＋ ～2＋组气促比例高于痰液细菌0 ＋组。3.多项 Logistic回归分析发现兄弟姐妹、居住地、被动吸烟、病程、发绀是痰液细菌3＋ ～4＋组的影响因素；性别、热峰〉38.5 ℃ 、母乳喂养、被动吸烟、年龄、病程和发绀是痰液细菌1＋ ～2＋组的影响因素。4.痰液细菌3＋ ～4＋组以重症肺炎多见。结论 喘息住院婴儿痰液细菌培养阳性常见，痰液细菌数量与临床特征存在相关性，重症肺炎患儿多见于痰液细菌培养数量高组。Objective To explore the relationship between the clinical features and the bacteria quantity con- firmed by semi-quantitative culture of sputum in hospitalized infants with wheezing diseases. Methods Nine hundred and fifty-seven patients with wheezing diseases were enrolled from Jan. 1,2010 to Dec. 31,2011 ,and their clinical cha- racteristics were collected. Respiratory secretions were collected on admission by the pathogenic examination. They were grouped into 3 groups by the bacteria quantity, and the predictive analytics statistical saftware 20.0 was used to analyze the relationship between the clinical features and the bacteria quantity confirmed by semi-quantitative culture of spu- tum. Results 1. A total of 372 （ 38.87% , 372/957 cases） patients had positive sputum cultures, and there were 585 patients in 0 ＋ group,225 patients in 1 ＋ -2 ＋ group,147 patients in 3 ＋ -4 ＋ group;the main pathogens in l ＋ - 2 ＋ group were haemophilus influenza （ 24.89% , 56/225 cases） and streptococcus pneumonia （ 16.00% , 36/225 ca- ses） ;the main pathogens in 3 ＋ -4 ＋ group were streptococcus pneumonia（54.42% ,80/147 cases） and haemophilus influenza（8.84%, 13/147 cases）. 2. Presence of siblings, cyanosis, neutrophils and C-reactive protein were higher in 3 ＋ - 4 ＋ group when compared with those of 0 ＋ group, shortness of breath was common in 1 ＋ - 2 ＋ group. 3. Multi- nomial Logistic regression analysis identified the presence of siblings, residence, passive smoking, course of disease and eyanosis were identified as risk factors in 3 ＋ - 4 ＋ group ; gender, fever peak 〉 38.5 ℃, breast-feeding, passive smo- king, age, course of disease and cyanosis were as risk factors in 1 ＋ - 2 ＋ group. 4. Severe pneumonia was common in 3 ＋ -4 ＋ group. Conclusions Bacterial are often detected in infants hospitaled with wheezy episodes, and bacteria quantity is correlated with clinical presentation. Severe pneumonia is common in higher bacteria quantity group.

关 键 词：婴儿 喘息 临床特征 细菌半定量培养 

分 类 号：R725.6[医药卫生—儿科]