我院儿童结核病情况及重症结核发病影响因素分析  

Analysis of children’s tuberculosis in our hospital and the influencing factors of severe tuberculosis

作　　者：肖丽涛[1] 徐鸣浩 王艳春[1] 朱婷燕 李全红[3] 杨小涛[1] XIAO Litao;XU Minghao;WANG Yanchun;ZHUN Tingyan;LI Quanhong;YANG Xiaotao(Department of Infectious Diseases,Kunming Children’s Hospital,Yunan Province,Kunming 650228,China;Department of Emergency,Kunming Children’s Hospital,Yunan Province,Kunming 650228,China;Department of Pharmacy,Kunming Children’s Hospital,Yunan Province,Kunming 650228,China)

机构地区：[1]昆明市儿童医院感染科,云南昆明650228 [2]昆明市儿童医院急诊科,云南昆明650228 [3]昆明市儿童医院药剂科,云南昆明650228

出　　处：《中国医药导报》2022年第6期60-63,共4页China Medical Herald

基　　金：云南省卫计委省级重点专科建设项目(云卫医发〔2018〕4号);云南省昆明市卫生健康委卫生科研项目(2020-14-04-011)。

摘　　要：目的探讨昆明市儿童医院(以下简称“我院”)儿童结核病情况及重症结核发病影响因素,以提出针对性预防措施,降低疾病的发生率。方法统计2016年1月至2020年12月我院收治的312例儿童结核病的临床资料,根据疾病严重情况分为重症结核组(87例)和非重症结核组(225例),分析儿童结核发病的临床特点、导致重症结核的影响因素。结果2016—2020年,我院收治的儿童结核住院患者逐年减少;儿童结核的临床表现主要以发热、咳嗽为主;其中男性发病多于女性,≥7岁患者发病最多见,其次为3~7岁年龄段;结核病高发于经济相对落后、环境污染严重、人口稠密且流动性大的地区。儿童重症结核的发病与年龄、居住环境、结核接触史、卡介苗接种史、营养状况有关(P<0.05)。logistic回归分析显示,年龄(OR=1.918,95%CI:1.319~2.642,P=0.008)、居住环境(OR=1.147,95%CI:1.096~1.253,P=0.001)、营养状况(OR=2.061,95%CI:1.437~2.712,P=0.042)、结核接触史(OR=2.168,95%CI:1.413~2.897,P=0.017)是儿童重症结核发病的危险因素,卡介苗接种是其保护因素(OR=0.887、95%CI:0.268~0.953,P=0.007)。结论应该针对儿童结核的临床特点和高危因素,提高认识,积极防治,以减少结核特别是重症结核在儿童中的发生。Objective To explore the situation of children’s tuberculosis in Kunming Children’s Hospital(hereinafter referred to as“our hospital”)and the influencing factors of severe tuberculosis in order to propose targeted preventive measures to reduce the incidence of the disease.Methods The clinical data of 312 children with tuberculosis admitted to our hospital from January 2016 to December 2020 were collected,and the clinical characteristics of children’s tuberculosis,according to the severity of the disease,they were divided into severe tuberculosis group(87 cases)and non-severe tuberculosis group(225 cases),the influencing factors of severe tuberculosis were analyzed.Results From 2016 to 2020,the number of inpatients with childhood tuberculosis in our hospital has decreased year by year;the clinical manifestations of childhood tuberculosis were mainly fever and cough;the incidence of Tuberculosis in males was more common than that in females,and the incidence was most common in patients aged seven and over,followed by the age group of three to seven years.The incidence of tuberculosis was high in areas with relatively backward economy,serious environmental pollution,dense population and high mobility.The incidence of severe tuberculosis in children was related to age,living environment,tuberculosis contact history,bacille calmette-guerin vaccination history,and nutritional status(P<0.05).Logistic regression analysis showed that age(OR=1.918,95%CI:1.319-2.642,P=0.008),living environment(OR=1.147,95%CI:1.096-1.253,P=0.001),nutritional status(OR=2.061,95%CI:1.437-2.712,P=0.042),history of tuberculosis exposure(OR=2.168,95%CI:1.413-2.897,P=0.017)were associated risk factors for severe tuberculosis in children,and bacille calmette-guerin vaccination was a protective factor(OR=0.887,95%CI:0.268-0.953,P=0.007).Conclusion We should focus on the clinical characteristics of childhood tuberculosis and the high-risk factors that lead to severe tuberculosis,raise awareness,pay close attention to those with high-risk fa

关 键 词：结核病 流行病学 儿童 重症患者 云南地区 

分 类 号：R529.9[医药卫生—内科学]