急性哮喘患儿肺部感染病原菌及其危险因素模型构建  

Pathogens isolated from acute asthma children with pulmonary infection and establishment of risk factor model

作　　者：姚男华 王雪玉[1] 蒋小丽 张祥[1] 陈雅琪 施跃琼 YAO Nan-hua;WANG Xue-yu;JIANG Xiao-li;ZHANG Xiang;CHEN Ya-qi;SHI Yue-qiong(Jianyang People's Hospital,Chengdu,Sichuan 641499,China)

机构地区：[1]简阳市人民医院儿科,四川成都641499 [2]简阳市人民医院检验科,四川成都641499

出　　处：《中华医院感染学杂志》2023年第23期3654-3658,共5页Chinese Journal of Nosocomiology

基　　金：四川省科研基金资助项目(2021HG02416)。

摘　　要：目的探究急性哮喘患儿肺部感染的病原菌分布特点及其危险因素,并构建回归方程。方法回顾性选取简阳市人民医院2020年1月-2022年12月收治的452例急性哮喘患儿,根据是否发生肺部感染,将其分为感染组(86例)和非感染组(366例)。统计急性哮喘患儿肺部感染的现况及病原菌分布特点;通过单因素及多因素分析法分析急性哮喘患儿肺部感染发生的危险因素,建立危险因素模型,并绘制受试者工作特征(ROC)曲线分析危险因素模型对急性哮喘患儿肺部感染发生的预测价值。结果86例急性哮喘肺部感染患儿共检出病原菌89株,其中革兰阴性菌61株,占比68.54%,革兰阳性菌18株,占比20.22%,真菌4株,占比4.49%,支原体6株,占比6.74%;多因素Logistic分析结果显示,哮喘发作次数、有合并鼻息肉或鼻窦炎或鼻中隔偏曲、抗菌药物使用时间、有应用糖皮质激素、家里有养动物、血清IgE水平高是急性哮喘患儿肺部感染发生的危险因素(P<0.05);据此危险因素模型:Logit(P)=-13.515+0.753×哮喘发作次数+0.789×有合并鼻息肉或鼻窦炎或鼻中隔偏曲+0.676×抗菌药物使用时间+0.771×有应用糖皮质激素+0.795×家里有养动物+0.904×血清IgE水平高;按照危险因素模型绘制预测急性哮喘患儿肺部感染发生的ROC曲线,结果显示诊断敏感度为80.23%、特异度为79.78%。结论急性哮喘患儿肺部感染的病原菌主要为革兰阴性菌,建立的危险因素模型预测急性哮喘患儿肺部感染发生的价值高,临床可据此予以针对性预防措施进而降低急性哮喘患儿肺部感染的发生风险。OBJECTIVE To investigate the characteristics of pathogenic distribution and risk factors for pulmonary infection in children with acute asthma,and to construct regression equation.METHODS A total of 452 children with acute asthma admitted to Jianyang People′s Hospital from Jan 2020 to Dec 2022 were analyzed retrospectively.According to whether pulmonary infection occurred,they were divided into the infection group(86 cases)and the non-infection group(366 cases).The status of pulmonary infection and pathogenic bacteria distribution in children with acute asthma were analyzed.The risk factors for the pulmonary infection in children with acute asthma were analyzed by univariate and multivariate analysis,and the risk factor model was established.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of the risk factor model for pulmonary infection in children with acute asthma.RESULTS A total of 89 strains of pathogenic bacteria were detected in 86 children with acute asthma pulmonary infection,among which 61 strains of gram-negative bacteria accounted for 68.54%,18 strains of gram-positive bacteria accounted for 20.22%,4 strains of fungi accounted for 4.49% and 6 strains of Mycoplasma accounted for 6.74%.Multivariate logistic analysis showed that the number of asthma attacks,complicated with nasal polyps or rhinosinusitis or nasal septum deviation,use of antibiotics,use of glucocorticoids,animals raised in the home and high serum IgE level were risk factors for pulmonary infection in children with acute asthma(P<0.05).Accordingly,the risk factor model was as follows:Logit(P)=-13.515+0.753×number of asthma attacks+0.789×complicated with nasal polyps or rhinosinusitis or nasal septum deviation+0.676×use of antibiotics+0.771×use of glucocorticoids+0.795×animals raised in the home+0.904×high serum IgE level.The ROC curve for the prediction of pulmonary infection in children with acute asthma was drawn according to the risk factor model.The results showed the diagnostic sensitiv

关 键 词：急性哮喘 肺部感染 病原菌 危险因素 预测模型 受试者工作特征曲线 

分 类 号：R725.6[医药卫生—儿科]