鼻咽部肺炎链球菌定植的婴幼儿喘息发作诱因探讨  

Discussion on the inducement of wheezing attack in infants with nasopharyngeal Streptococcus pneumonia colonization

作　　者：戴雅静 杨燕珍 陈腾 蔡梦云 DAI Yajing;YANG Yanzhen;CHEN Teng;CAI Mengyun(Department of Pediatrics,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou 363000,China)

机构地区：[1]福建医科大学附属漳州市医院儿科,福建漳州363000

出　　处：《中国现代医生》2022年第12期60-63,共4页China Modern Doctor

摘　　要：目的探讨鼻咽部肺炎链球菌定植的婴幼儿首次喘息发作的临床特点。方法回顾性分析2018年1月至2020年1月收住福建医科大学附属漳州市医院的763例鼻咽部分泌物培养肺炎链球菌阳性的婴幼儿的临床资料,根据病程中是否有喘息表现,分为喘息组161例(21.10%)与非喘息组602例(78.90%),比较两组患儿的性别、年龄、入院季节、特应质、重症、呼吸道病毒7项抗原检测、肺炎支原体血清学。结果喘息组与非喘息组相比,单因素分析提示小婴儿(63.35%∶50.00%;χ^(2)=9.090、P<0.001、OR=0.459)、特应质患儿(30.43%∶14.62%;χ^(2)=21.570、P<0.001、OR=2.619)、重症患儿(24.22%∶8.64%;χ^(2)=29.380、P<0.001、OR=3.585)、肺炎支原体感染(36.03%∶27.71%;χ^(2)=4.190;P=0.040、OR=1.813)及呼吸道合胞病毒感染(27.33%∶18.27%;χ^(2)=6.470、P=0.010、OR=1.459)是诱发喘息的危险因素;二元logistic回归分析提示重症(P<0.001,OR=3.585)、特应质(P<0.001,OR=2.619)、肺炎支原体感染(P=0.040,OR=1.813)是诱发喘息的风险,而年龄(P<0.001,OR=0.459)是保护因素。结论鼻咽部存在肺炎链球菌定植的特应质小婴儿,当发生肺炎支原体感染时,更易诱发喘息的发作,出现重症表现,值得关注。Objective To investigate the clinical characteristics of the first wheezing attack in infants with nasopharyngeal Streptococcus pneumonia colonization.Methods The clinical data of 763 infants with positive Streptococcus pneumonia in nasopharyngeal secretion culture admitted to Zhangzhou Affiliated Hospital of Fujian Medical University from January 2018 to January 2020 were retrospectively analyzed.The patients were divided into the wheezing group(n=161,21.10%)and the non-wheezing group(n=602,78.90%)according to whether there were wheezing manifestations during the disease.The gender,age,the season of admission,atopy,critically ill,detection of 7 antigens of respiratory viruses,and serology of Mycoplasma pneumonia were compared between the two groups.Results Compared with the non-wheezing group,univariate analysis showed that young infants(63.35%∶50.00%;χ^(2)=9.090,P<0.001,OR=0.459),atopy children(30.43%∶14.62%;χ^(2)=21.570,P<0.001,OR=2.619),critically ill children(24.22%∶8.64%;χ^(2)=29.380,P<0.001,OR=3.585),mycoplasma pneumonia infection(36.03%∶27.71%;χ^(2)=4.190;P=0.040,OR=1.813)and respiratory syncytial virus infection(27.33%∶18.27%;χ^(2)=6.470,P=0.010,OR=1.459)were risk factors for wheezing.However,binary logistics regression showed that critically ill(P<0.001,OR=3.585),atopy(P<0.001,OR=2.619),mycoplasma pneumonia infection(P=0.040,OR=1.813)were risk factors for wheezing,while age(P<0.001,OR=0.459)was a protective factor.Conclusion Atopy little infants with Streptococcus pneumonia colonization in the nasopharynx are more likely to induce wheezing and severe manifestations when Mycoplasma pneumonia infection occurs,which deserves our attention.

关 键 词：肺炎链球菌 婴幼儿 喘息 特应质 

分 类 号：R725.6[医药卫生—儿科]