目的 分析影响3~6岁儿童反复发生上呼吸道感染的相关因素,为防治小儿上呼吸道感染提供参考依据。方法 选取160例3~6岁患有反复上呼吸道感染的患儿作为病例组,并选取160例3~6岁健康儿童作为对照组,调查儿童一般人口学资料、父母相关资料、生活环境、营养状况及微量元素含量等,应用Logistic回归分析3~6岁儿童反复发生上呼吸道感染的相关影响因素。结果 1)病例组儿童微量元素中铁、钙和锌水平均显著低于对照组(t=-4.31、-7.98、-7.53,P均<0.05);2)Logistic回归分析显示,母亲文化程度高中以上是儿童反复呼吸道感染的保护性因素(OR=0.279,P=0.024),父母有过敏史(OR=1.412,P=0.004)、家庭成员吸烟(OR=1.565,P=0.001)、每日户外活动时间<2 h(OR=4.963,P=0.033),年抗菌药物使用次数≥3次(OR=11.894,P<0.001)均是儿童反复呼吸道感染的危险性因素。结论 儿童缺乏钙、铁、锌等微量元素容易患反复上呼吸道感染,母亲文化程度高中以上是儿童反复呼吸道感染的保护性因素。避免吸二手烟、减少抗菌药物的使用次数、增加每日户外运动时间可预防儿童反复上呼吸道感染的发生。
Abstract
Objective To explore factors influencing the recurrent upper respiratory tract infection (RRTI) in children aged 3-6 years.Methods Totally 160 children aged 3-6 years with RRTI were selected as case group, and 160 healthy children at the same age were selected as control group. Children′s demographics data, parents′ data, children′s living environment, nutritional status and trace elements were collected. And the influencing factors of RRTI were analyzed by Logistic regression in 3 to 6-year-old children.Results 1) The levels of iron, calcium and zinc in children were significantly lower than those in control group (t =-4.31,-7.98,-7.53, all P <0.05);2)Logistic regression analysis showed that mothers′ education level above high school was the protective factor of RRTI in children (OR=0.279, P=0.024), parents with allergies history (OR=1.412, P=0.004), smoking of family members (OR=1.565, P=0.001), outdoor activities time < 2 h/d (OR=4.963, P=0.033), antimicrobial use≥ 3 times/year (OR=11.894, P<0.001) were all significantly risk factors for RRTI in children.Conclusion Children lack of calcium, iron, zinc and other trace elements are prone to develop RRTI. Maternal education level above high school was the protective factor of RRTI in children. Avoiding second-hand smoking, decreasing the frequency of antimicrobial use and increasing the daily outdoor activities time can prevent the occurrence of RRTI.
关键词
反复发生上呼吸道感染 /
小儿 /
影响因素 /
Logistic回归
Key words
recurrent upper respiratory tract infection /
children /
influencing factors /
Logistic regression
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参考文献
[1] Xiao Q, Ren L, Zheng S, et al. Prevalence and molecular characterizations of enterovirus D68 among children with acute respiratory infection in China between 2012 and 2014[J].Sci Rep,2015,5:16639.
[2] 王丽平,李鲁明,梁海丽. 儿童反复上呼吸道感染的社区干预效果评价[J]. 现代预防医学,2014,41(4):633-634, 637.
[3] Woicka-Kolejwa K, Zaczeniuk M, Majak P, et al. Food allergy is associated with recurrent respiratory tract infections during childhood[J]. Postepy Dermatol Alergol,2016,33(2):109-113.
[4] 庄桃. 热毒宁注射液治疗小儿病毒性上呼吸道感染的临床疗效观察[J]. 实用心脑肺血管病杂志,2015(2):110-111, 117.
[5] Raniszewska A, Gorska E, Kotula I, et al. Recurrent respiratory tract infections in children-analysis of immunological examinations[J]. Cent Eur J Immunol,2015,40(2):167-173.
[6] 汪叶红,王桂兰,杨赛. 婴幼儿饮食结构与反复上呼吸道感染及喘息的关系[J]. 广东医学,2012,33(17):2600-2603.
[7] Estrada J, Najera M, Pounds N, et al. Clinical and serologic response to the 23-valent polysaccharide pneumococcal vaccine in children and teens with recurrent upper respiratory tract infections and selective antibody deficiency[J].Pediatr Infect Dis J,2016,35(2):205-208.
[8] 吴学杰,薛明明,黄君龄,等. 疏风解毒胶囊联合抗生素治疗老年急性细菌性上呼吸道感染的临床疗效观察[J]. 实用心脑肺血管病杂志,2015(3):97-99.
[9] Kuznetzova OY, Gorshenina AP, Maximovskaya LN. Prevention of the recurrent herpetic stomatitis in employees of Kazan city industrial enterprises frequently suffering from acute respiratory viral infections[J]. Stomatologiia (Mosk),2016,95(5):24-26.
[10] Toivonen L, Vuononvirta J, Mertsola J, et al. Polymorphisms of mannose-binding lectin and toll-like receptors 2, 3, 4, 7 and 8 and the risk of respiratory infections and acute otitis media in children[J]. Pediatr Infect Dis J,2017,36(5):e114-e122.
[11] 林燕,王亚利,王鑫国,等. 反复上呼吸道感染肺卫气虚证的血浆代谢组学特征及玉屏风颗粒干预的临床疗效[J]. 中医杂志,2015,56(15):1302-1306.
[12] van deVosse E, van Ostaijen-Ten DM, Vermaire R, et al. Recurrent respiratory tract infections (RRTI) in the elderly:a late onset mild immunodeficiency?[J]. Clin Immunol,2017,180:111-119.
[13] 郝素莲. 坝上3~6岁儿童反复上呼吸道感染的病因调查与分析[J]. 山西医药杂志,2015,44(13):1483-1485.
基金
番禺区科技计划项目(2017-Z04-67)