中国妇幼健康研究
中國婦幼健康研究
중국부유건강연구
CHINESE JOURNAL OF MATERNAL AND CHILD HEALTH RESEARCH
2015年
2期
204-206,230
,共4页
儿童%重症社区获得性肺炎%危险因素%病原谱
兒童%重癥社區穫得性肺炎%危險因素%病原譜
인동%중증사구획득성폐염%위험인소%병원보
children%severe community-acquired pneumonia ( SCAP)%risk factor%pathogen spectrum
目的：了解儿童重症社区获得性肺炎（ SCAP）的病原谱，并对其致病危险因素进行分析。方法以2008年1月至2013年12月期间来武汉市第八医院儿科就诊的4050例社区获得性肺炎患儿为研究对象，从中筛选出重症社区获得性肺炎患儿526例，采集526例患儿的痰标本进行细菌检测和病毒检测；对上述研究对象进行病毒RNA提取及基因扩增，应用非条件Logistic回归进行影响因素分析。结果重症社区获得性肺炎以幼儿发病较常见，细菌检出率39．16％，病毒检出率37．64％；年龄、合并基础疾病、呼吸道合胞病毒（ RSV）感染、是否合并胸腔积液、血红蛋白浓度、症状持续时间、白细胞计数等是儿童SCAP发病的主要影响因素（OR值分别为0．652、5．660、1．890、1．310、1．580、1．390、1．450，均P＜0．05）；小于1岁者感染程度最高，占55．7％，到6岁以上感染程度降低到2．5％。结论重症社区获得性肺炎发病呈现明显的季节性和年龄性，细菌是主要病原，合并基础性疾病、RSV感染和革兰氏阴性菌是其发病的主要影响因素。
目的：瞭解兒童重癥社區穫得性肺炎（ SCAP）的病原譜，併對其緻病危險因素進行分析。方法以2008年1月至2013年12月期間來武漢市第八醫院兒科就診的4050例社區穫得性肺炎患兒為研究對象，從中篩選齣重癥社區穫得性肺炎患兒526例，採集526例患兒的痰標本進行細菌檢測和病毒檢測；對上述研究對象進行病毒RNA提取及基因擴增，應用非條件Logistic迴歸進行影響因素分析。結果重癥社區穫得性肺炎以幼兒髮病較常見，細菌檢齣率39．16％，病毒檢齣率37．64％；年齡、閤併基礎疾病、呼吸道閤胞病毒（ RSV）感染、是否閤併胸腔積液、血紅蛋白濃度、癥狀持續時間、白細胞計數等是兒童SCAP髮病的主要影響因素（OR值分彆為0．652、5．660、1．890、1．310、1．580、1．390、1．450，均P＜0．05）；小于1歲者感染程度最高，佔55．7％，到6歲以上感染程度降低到2．5％。結論重癥社區穫得性肺炎髮病呈現明顯的季節性和年齡性，細菌是主要病原，閤併基礎性疾病、RSV感染和革蘭氏陰性菌是其髮病的主要影響因素。
목적：료해인동중증사구획득성폐염（ SCAP）적병원보，병대기치병위험인소진행분석。방법이2008년1월지2013년12월기간래무한시제팔의원인과취진적4050례사구획득성폐염환인위연구대상，종중사선출중증사구획득성폐염환인526례，채집526례환인적담표본진행세균검측화병독검측；대상술연구대상진행병독RNA제취급기인확증，응용비조건Logistic회귀진행영향인소분석。결과중증사구획득성폐염이유인발병교상견，세균검출솔39．16％，병독검출솔37．64％；년령、합병기출질병、호흡도합포병독（ RSV）감염、시부합병흉강적액、혈홍단백농도、증상지속시간、백세포계수등시인동SCAP발병적주요영향인소（OR치분별위0．652、5．660、1．890、1．310、1．580、1．390、1．450，균P＜0．05）；소우1세자감염정도최고，점55．7％，도6세이상감염정도강저도2．5％。결론중증사구획득성폐염발병정현명현적계절성화년령성，세균시주요병원，합병기출성질병、RSV감염화혁란씨음성균시기발병적주요영향인소。
Objective To master the pathogen spectrum of severe community-acquired pneumonia (SCAP) in children and to analyze the risk factors.Methods A total of 4 050 children with CAP who visiting pediatrics department of Eighth Hospital of Wuhan City from January 2008 to December 2013 were studied.Of these children, 526 with SCAP were chosen as subjects.Sputum samples were collected for bacteria and virus detections.RNA extraction and gene amplification of the virus were performed for these subjects.Unconditional Logistic regression analysis was conducted to analyze influencing factors.Results SCAP was more commonly observed in children.The detection rate was 39.16% for bacteria and 37.64% for virus, respectively.Age, underlying diseases, RSV infection, whether pleural effusion presented or not, hemoglobin concentration, duration of symptoms and white blood cell count were the major influencing factors of SCAP in children (OR value was 0.652, 5.660, 1.890, 1.310, 1.580, 1.390 and 1.450, respectively, all P<0.05).Infection rate was highest in patients <1 year old, which reached 55.7%.But it decreased to 2.5% in patients >6 years old.Conclusion SCAP is obviously related to season and age.Its major pathogens are bacteria.Underlying diseases, RSV infection and gram-negative bacteria are the main influencing factors of the onset of this disease.
