哮喘合并社区获得性肺炎儿童的临床特征分析  

Clinical characteristics of children with asthma complicated with community acquired pneumonia

作　　者：翟苏雅 茹凉[1] ZHAI Suya;RU Liang(Department of Pediatrics,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830011,China)

机构地区：[1]新疆医科大学第一附属医院儿科中心儿内二科,新疆乌鲁木齐830011

出　　处：《中国医学工程》2023年第7期69-74,共6页China Medical Engineering

摘　　要：目的探讨哮喘合并社区获得性肺炎患儿的临床特征,分析影响哮喘合并社区获得性肺炎病情严重程度的危险因素。方法回顾性收集2021年6月1日至2022年5月31日新疆医科大学第一附属医院儿科收治的社区获得性肺炎住院患儿临床资料,根据是否合并支气管哮喘分为普通社区获得性肺炎组及哮喘合并社区获得性肺炎组,对照分析两组患儿人口学、临床表现、影像学、病原学特征以及两组患儿的临床结局等指标,探讨哮喘合并社区获得性肺炎儿童的临床特点,分析影响哮喘合并社区获得性肺炎严重程度的影响因素。结果共收集294例社区获得性肺炎患儿符合纳入标准,根据是否合并支气管哮喘分为哮喘合并社区获得性肺炎(AS-CAP)组132例、普通社区获得性肺炎(CAP)组162例。两组临床特点基本相似,AS-CAP组患儿平均年龄较大,肺炎严重程度较轻,且症状消失天数较早,住院天数较短,AS-CAP组患儿体温、呼吸频率、C反应蛋白、血降钙素原、白介素6、血沉、乳酸脱氢酶平均水平均较低,而红细胞压积和免疫球蛋白E(IgE)水平较高(P<0.05)。两组患儿分离病原菌均以肺炎链球菌为最常见,两组患儿肺部影像学特点以斑片状改变为主。二元Logistic回归分析证实,发病前哮喘部分或完全控制(OR=0.265,95%CI:0.071~0.994)、未进行肺泡灌洗(OR=0.125,95%CI:0.027~0.587)、动脉血PO_(2)升高(OR=0.920,95%CI:0.851~0.994)等3个因素是AS-CAP患儿病情严重程度的保护因素(P<0.05)。结论哮喘合并社区获得性肺炎临床特征与普通社区获得性肺炎临床特征相似,哮喘合并社区获得性肺炎组患儿病情严重程度较轻,且症状消失天数较早,住院天数较短。哮喘控制水平、氧分压、是否行肺泡灌洗是哮喘合并社区获得性肺炎患儿病情严重程度的影响因素。【Objective】To explore the clinical characteristics of children with asthma complicated with community acquired pneumonia,and analyze the risk factors affecting the severity of asthma complicated with community acquired pneumonia.【Methods】The clinical data of hospitalized children with community-acquired pneumonia admitted to the Department of Pediatrics of the First Affiliated Hospital of Xinjiang Medical University from June 1,2021 to May 31,2022 were retrospectively collected.They were divided into community-acquired pneumonia group and asthma with community-acquired pneumonia group according to whether bronchial asthma was combined.The demographic,clinical manifestations,imaging,pathogenic characteristics and clinical outcomes of the two groups were compared to explore the clinical characteristics of children with asthma combined with community acquired pneumonia,and analyze the influencing factors of the severity of asthma combined with community acquired pneumonia.【Results】A total of 294 children with community-acquired pneumonia met the inclusion criteria.They were divided into AS-CAP group(132 cases)and CAP group(162 cases)according to whether they had bronchial asthma,and the clinical characteristics of the children in the AS-CAP group were basically similar.The average age of the children in the AS-CAP group was larger,the severity of pneumonia was less,the days of symptom disappearance were earlier,and the days of hospitalization were shorter.The average level of the temperature,respiratory rate,C-reactive protein,procalcitonin,interleukin-6,erythrocyte sedimentation rate and lactate dehydrogenase were low,while hematocrit and IgE were high(P<0.05).Streptococcus pneumoniae was the most common pathogen isolated from the two groups of children.The imaging characteristics of the lungs of the two groups of children were mainly patchy changes.Binary logistic regression analysis confirmed that three factors,including partial or complete control of asthma before onset(OR=0.265,95%CI:0.071-0.994),ab

关 键 词：儿童哮喘 社区获得性肺炎 临床特征 

分 类 号：R725[医药卫生—儿科]