中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2014年
7期
506-509
,共4页
赵永利%刘正娟%白雪梅%王玉川%李国华
趙永利%劉正娟%白雪梅%王玉川%李國華
조영리%류정연%백설매%왕옥천%리국화
肥胖%肺炎%住院时间%免疫功能受损%儿童
肥胖%肺炎%住院時間%免疫功能受損%兒童
비반%폐염%주원시간%면역공능수손%인동
Obesity%Pneumonia%Hospital stay%Impaired immunity%Child
目的 探讨肥胖及超体质量对普通肺炎患儿平均住院时间及总病程的影响.方法 共有455例2～7岁普通肺炎患儿纳入本研究,包括147例肥胖儿童、141例超体质量儿童以及167例正常体质量儿童.然后根据年龄进一步分为≥2～4岁年龄组和≥4 ～7岁年龄组.通过查阅病历管理系统,收集患儿资料,包括性别、年龄、体质量、身高、住院时间、总病程、外周血细胞计数(白细胞、中性粒细胞、单核细胞及淋巴细胞)、C反应蛋白(CRP)、红细胞沉降率(ESR)、体液免疫指标(IgG、IgA)、细胞免疫指标(CD4+T、CD8+T)及反复肺炎病史.结果 在≥2 ～4岁年龄组,肥胖及超体质量儿童的平均住院时间均较正常体质量儿童长(P=0.037、0.009),肥胖儿童的总病程也较正常体质量儿童延长(P=0.014);在≥4 ～7岁年龄组,肥胖及超体质量儿童的平均住院时间及总病程均较正常体质量儿童长(平均住院时间:P=0.002、0.000;总病程:P=0.004、0.001).在≥2 ～4岁年龄组,肥胖、超体质量及正常体质量儿童外周血细胞计数、CRP、ESR、IgG、IgA、CD4+T、CD8+T、CD4+T/CD8+T及反复肺炎病史差异均无统计学意义(P均＞0.05);在4～7岁年龄组,肥胖及超体质量及正常体质量儿童外周血细胞计数、ESR比较差异均无统计学意义(P均＞0.05).但肥胖、超体质量儿童体液(IgG)及细胞免疫指标(CD4+T、CD4+ T/CD8+ T)均较正常体质量儿童下降,肥胖儿童表现更为明显,并且肥胖及超体质量儿童更易患反复肺炎(P＜0.05).结论 ≥2 ～7岁肥胖及超体质量的普通肺炎儿童较正常体质量儿童需要更长的住院时间,其肺炎总病程也相对延长.免疫功能受损在≥4 ～7岁年龄组患儿中发挥主要作用,而在≥2 ～4岁年龄组中,非免疫因素可能起主要作用.
目的 探討肥胖及超體質量對普通肺炎患兒平均住院時間及總病程的影響.方法 共有455例2～7歲普通肺炎患兒納入本研究,包括147例肥胖兒童、141例超體質量兒童以及167例正常體質量兒童.然後根據年齡進一步分為≥2～4歲年齡組和≥4 ～7歲年齡組.通過查閱病歷管理繫統,收集患兒資料,包括性彆、年齡、體質量、身高、住院時間、總病程、外週血細胞計數(白細胞、中性粒細胞、單覈細胞及淋巴細胞)、C反應蛋白(CRP)、紅細胞沉降率(ESR)、體液免疫指標(IgG、IgA)、細胞免疫指標(CD4+T、CD8+T)及反複肺炎病史.結果 在≥2 ～4歲年齡組,肥胖及超體質量兒童的平均住院時間均較正常體質量兒童長(P=0.037、0.009),肥胖兒童的總病程也較正常體質量兒童延長(P=0.014);在≥4 ～7歲年齡組,肥胖及超體質量兒童的平均住院時間及總病程均較正常體質量兒童長(平均住院時間:P=0.002、0.000;總病程:P=0.004、0.001).在≥2 ～4歲年齡組,肥胖、超體質量及正常體質量兒童外週血細胞計數、CRP、ESR、IgG、IgA、CD4+T、CD8+T、CD4+T/CD8+T及反複肺炎病史差異均無統計學意義(P均＞0.05);在4～7歲年齡組,肥胖及超體質量及正常體質量兒童外週血細胞計數、ESR比較差異均無統計學意義(P均＞0.05).但肥胖、超體質量兒童體液(IgG)及細胞免疫指標(CD4+T、CD4+ T/CD8+ T)均較正常體質量兒童下降,肥胖兒童錶現更為明顯,併且肥胖及超體質量兒童更易患反複肺炎(P＜0.05).結論 ≥2 ～7歲肥胖及超體質量的普通肺炎兒童較正常體質量兒童需要更長的住院時間,其肺炎總病程也相對延長.免疫功能受損在≥4 ～7歲年齡組患兒中髮揮主要作用,而在≥2 ～4歲年齡組中,非免疫因素可能起主要作用.
목적 탐토비반급초체질량대보통폐염환인평균주원시간급총병정적영향.방법 공유455례2～7세보통폐염환인납입본연구,포괄147례비반인동、141례초체질량인동이급167례정상체질량인동.연후근거년령진일보분위≥2～4세년령조화≥4 ～7세년령조.통과사열병력관리계통,수집환인자료,포괄성별、년령、체질량、신고、주원시간、총병정、외주혈세포계수(백세포、중성립세포、단핵세포급림파세포)、C반응단백(CRP)、홍세포침강솔(ESR)、체액면역지표(IgG、IgA)、세포면역지표(CD4+T、CD8+T)급반복폐염병사.결과 재≥2 ～4세년령조,비반급초체질량인동적평균주원시간균교정상체질량인동장(P=0.037、0.009),비반인동적총병정야교정상체질량인동연장(P=0.014);재≥4 ～7세년령조,비반급초체질량인동적평균주원시간급총병정균교정상체질량인동장(평균주원시간:P=0.002、0.000;총병정:P=0.004、0.001).재≥2 ～4세년령조,비반、초체질량급정상체질량인동외주혈세포계수、CRP、ESR、IgG、IgA、CD4+T、CD8+T、CD4+T/CD8+T급반복폐염병사차이균무통계학의의(P균＞0.05);재4～7세년령조,비반급초체질량급정상체질량인동외주혈세포계수、ESR비교차이균무통계학의의(P균＞0.05).단비반、초체질량인동체액(IgG)급세포면역지표(CD4+T、CD4+ T/CD8+ T)균교정상체질량인동하강,비반인동표현경위명현,병차비반급초체질량인동경역환반복폐염(P＜0.05).결론 ≥2 ～7세비반급초체질량적보통폐염인동교정상체질량인동수요경장적주원시간,기폐염총병정야상대연장.면역공능수손재≥4 ～7세년령조환인중발휘주요작용,이재≥2 ～4세년령조중,비면역인소가능기주요작용.
Objective To study the effect of obesity and overweight on the hospital stays and total course of common pneumonia in children and the possible reasons.Methods A total of 455 children with common pneumonia aged from 2 to 7 years were enrolled in this study,including 147 obese children,141 overweight children and 167 normal weight children.Then all the children were divided into 2 groups based on age:≥ 2-4 years group and ≥ 4-7 years group.The information of the patients was collected from the medical records management system of our hospital,and including gender,age,weight,height,hospital stays,total course,peripheral blood cell counts (white blood cell,neutrophil,monocyte and lymphocyte),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),IgG,IgA,CD4 + T,CD8 +T and the history of recurrent pneumonia.Results In ≥ 2-4 years group,the average length of the hospital stays of common pneumonia in obese and overweight children was longer than that in the normal weight children(P =0.037,0.009),and the total course of common pneumonia in obese children was longer than that in the normal weight children (P =0.014).In ≥ 4-7 years group,the average length of the hospital stays and total course of common pneumonia in obese and overweight children were longer than those in the normal weight children (the hospital stay:P =0.002,0.000,the total course:P =0.004,0.001).In ≥2-4 years group,the peripheral blood cell counts(white blood cell,neutrophil,monocyte and lymphocyte),CRP,ESR,IgG,IgA,CD4 + T,CD8 + T,CD4 + T/CD8 + T and the history of recurrent pneumonia were of no significant difference among obese,overweight and normal weight children (all P ＞0.05).In ≥4-7 years group,the peripheral blood cell counts(white blood cell,neutrophil,monocyte and lymphocyte),and ESR were of no significant difference among obese,overweight and normal weight children (all P ＞ 0.05),but the levels of IgG,CD4 + T and CD4 + T/CD8 + T in obese and overweight children were lower than those in the normal weight children,and the obese children were more notable in this aspect (P ＜ 0.05).And obese and overweight children were more likely to suffer from recurrent pneumonia.Conclusions Obese and overweight children with common pneumonia aged from 2 to 7 years may need longer hospital stay and total course than normal weight children.Impaired immunity may be the main reason for the ≥4-7 years group,but in the ≥2-4 years old group,it may be attribute to some non-immune factors.
