急性哮喘并发肺部感染患儿病原学及影响因素分析  

Distribution of pathogens isolated from acute asthma children complicated with pulmonary infection and influencing factors

作　　者：关艳华[1] 刘淑霞[1] 赵明耀[2] 金道欣[1] 刘方[1] GUAN Yan-hua;LIU Shu-xia;ZHAO Ming-yao;JIN Dao-xin;LIU Fang(Luohe Medical College,Luohe,Henan 462002,China)

机构地区：[1]漯河医学高等专科学校护理系,河南漯河462002 [2]郑州大学基础部病理生理教研室,河南郑州450000

出　　处：《中华医院感染学杂志》2019年第14期2232-2236,共5页Chinese Journal of Nosocomiology

基　　金：河南省教育厅科学技术研究重点基金资助项目(122300410294)

摘　　要：目的研究急性哮喘并发肺部感染患儿病原菌构成及其影响因素。方法选取2016年9月-2018年2月医院急性哮喘患儿568例,监测病原菌构成,建立多元Logistic逐步回归模型分析感染影响因素。结果肺部感染41例、感染率7.22%。共分离菌株51株、检出率8.98%,革兰阴性菌构成比68.63%,革兰阳性菌构成比11.76%。具有统计意义的单因素包括年龄、哮喘发作次数、鼻部疾病、病原菌种类、抗菌药物使用时间、使用激素或氨茶碱次数(P<0.05)。急性哮喘并发感染患儿Treg、Th1、Th2、Th17百分率、CD4^+/CD8^+比值高于急性哮喘未并发感染患儿,CD4^+、CD8^+、FEV1/FVC百分率低于急性哮喘未并发感染患儿(P<0.05)。Logistic回归模型显示哮喘发作次数是影响因素,CD4^+T细胞亚群、T淋巴细胞亚群是保护性因素。结论急性哮喘并发肺部感染病原菌以革兰阴性菌为主,早期目标性识别感染影响因素,利于降低急性哮喘患儿肺部感染率。OBJECTIVE To investigate the distribution of pathogens isolated from acute asthma children complicated with pulmonary infection and analyze the influencing factors. METHODS A total of 568 children with acute asthma who were treated in the hospital from Sep 2016 to Feb 2018 were enrolled in the study, the constituent ratios of pathogens was monitored, and the multivariate logistic stepwise regression analysis was performed for the influencing factors. RESULTS Totally 41 children had pulmonary infection, with the infection rate 7.22%. Totally 51 strains of pathogens were isolated, 68.63% of which were gram-negative bacteria, and 11.76% were gram-positive bacteria, with the isolation rate 8.98%. Univariate analysis showed that there were significant differences in age, number of times of asthma attack, nasal disease, species of pathogens, time of use of antibiotics and use of hormones or aminophylline(P<0.05). The percentages of Treg, Th1, Th2 and Th17 as well as the ratio of CD4^+ to CD8^+ were significantly higher in the acute asthma children complicated with pulmonary infection than in the acute asthma children without pulmonary infection;the percentages of CD4^+, CD8^+ and FEV1/FVC of the acute asthma children complicated with pulmonary infection were significantly lower than those of the acute asthma children without pulmonary infection(P<0.05). The logistic regression analysis indicated that the number of times of asthma attack was the influencing factor, and the CD4^+T cell subsets and T lymphocyte subsets were the protective factors. CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated from the acute asthma children complicated with pulmonary infection. It is necessary to identify the influencing factors for the infection in early stage so as to reduce the incidence of pulmonary infection in the acute asthma children.

关 键 词：急性哮喘 肺部感染 病原菌 影响因素 LOGISTIC 

分 类 号：R725.6[医药卫生—儿科]