CAJ | 학술논문

目的：探讨肺炎支原体(MP)肺炎治愈一年内儿童发生反复呼吸道感染(RRTI)的情况及其影响因素。方法选择MP肺炎治愈并完成一年随访的133例患儿为研究对象，检测其治愈出院时及出院后3、6、9、12个月时MP-IgM、MP-IgG双抗体滴度，免疫功能，并记录是否发生呼吸道感染及呼吸道感染部位，一年内用药情况，并进行分析。结果完成随访的133例患儿中，治愈后一年内RRTI发生率为31.58%。多元logistic回归分析结果显示，年龄为3~6岁(OR=2.29，95%CI：1.13~4.64)；抗体持续阳性或者阴转阳(OR=4.47，95%CI：1.47~13.65)；CD4/CD8降低(OR=10.26，95%CI：3.30~31.90)；IgA低下(OR=1.90，95%CI：1.06~3.40)是发生RRTI的独立危险因素；使用免疫增强剂(OR=0.29，95%CI：0.11~0.78)是预防发生反复呼吸道感染的独立保护因素。在MP抗体持续阳性和阴转阳的85例患儿中，40例无临床症状应用抗生素，16例(40.00%)发生RRTI；45例未用抗生素，18例(40.00%)发生RRTI，两组间差异无统计学意义(P>0.05)。结论 MP肺炎治愈后一年内免疫功能紊乱的患儿容易发生RRTIs，使用免疫增强剂可降低RRTI发生率。MP抗体持续阳性和阴转阳患儿，在无临床症状时应用抗生素不能预防RRTI。
목적：탐토폐염지원체(MP)폐염치유일년내인동발생반복호흡도감염(RRTI)적정황급기영향인소。방법선택MP폐염치유병완성일년수방적133례환인위연구대상，검측기치유출원시급출원후3、6、9、12개월시MP-IgM、MP-IgG쌍항체적도，면역공능，병기록시부발생호흡도감염급호흡도감염부위，일년내용약정황，병진행분석。결과완성수방적133례환인중，치유후일년내RRTI발생솔위31.58%。다원logistic회귀분석결과현시，년령위3~6세(OR=2.29，95%CI：1.13~4.64)；항체지속양성혹자음전양(OR=4.47，95%CI：1.47~13.65)；CD4/CD8강저(OR=10.26，95%CI：3.30~31.90)；IgA저하(OR=1.90，95%CI：1.06~3.40)시발생RRTI적독립위험인소；사용면역증강제(OR=0.29，95%CI：0.11~0.78)시예방발생반복호흡도감염적독립보호인소。재MP항체지속양성화음전양적85례환인중，40례무림상증상응용항생소，16례(40.00%)발생RRTI；45례미용항생소，18례(40.00%)발생RRTI，량조간차이무통계학의의(P>0.05)。결론 MP폐염치유후일년내면역공능문란적환인용역발생RRTIs，사용면역증강제가강저RRTI발생솔。MP항체지속양성화음전양환인，재무림상증상시응용항생소불능예방RRTI。
Objective To investigate the occurrence trend and risk factors of recurrent respiratory tract infection during the ifrst year after Mycoplasma pneumoniae pneumonia (MPP) in children. Methods The clinical data of 133 children complete-ly recoved from MPP and one year follow-up after MPP were included in this study, MPP IgM IgG double antibody titer were measured in different time slots (3 month, 6 months, 9 months, 12 months) after discharge. Information on frequency of recurrent respiratory tract infections, respiratory tract infection site, and drug use within one year were collected. Possible factors affecting the occurrence of recurrent respiratory tract infection were analyzed by means of single factor and multi factor analyses. Results In 133 patients, the recurrent rate was 31.58%in the ifrst year;aged 3-6 years old (OR=2.29,95%CI:1.13~4.64), or continuous positive or negative to positive antibodies (OR=4.47,95%CI:1.47~13.65), or low CD4/CD8 (OR=10.26,95%CI:3.30~31.90), or low IgA (OR=1.90,95%CI:1.06~3.40) is independent risk factor of recurrent respiratory tract after MPP;immune enhancer therapy is an independent protective factor (OR=0.29,95%CI:0.11~0.78). Conclusions Immune function disorders in the ifrst year after MPP were independent risk factors of recurrent respiratory tract infection. MP antibody positive without clinical symptoms and sustained antibody positive can not prevent the recurrence of respiratory tract infection without use of antibiotics. Immune enhancer was advocate to adjust immune function and reduce the incidence of repeated respiratory tract infection.