小儿反复呼吸道感染危险因素回顾性调查

Retrospective Study on Risk Factors of Recurrent Respiratory Tract Infection in Children

目的回顾性分析导致小儿反复呼吸道感染(recurrent respiratory tract infection,RRTI)的危险因素,以期为临床预防提供理论依据。方法收集2016—2022年本地区各医院收治的呼吸道感染患儿567例,其中达到RRTI诊断标准者138例作为研究组,其余429例未达RRTI诊断标准者作为对照组。通过自行设计调查问卷的方式对入组患儿进行调查,包括一般情况、出生情况、喂养情况、既往病史、治疗情况和相关营养状况指标。对收集的数据进行统计分析,筛选导致小儿RRTI的危险因素。结果单因素分析显示,研究组早产、剖宫产、非母乳喂养、被动吸烟、扁桃体肿大、腺样体肥大和过敏性疾病比例高于对照组,差异有统计学意义(P<0.05);而血红蛋白、白蛋白、维生素A、维生素D、钙离子、铁离子和锌离子水平低于对照组,差异有统计学意义(P<0.05)。多因素分析显示,在剔除分娩方式和钙离子的影响后,早产、非母乳喂养、被动吸烟、扁桃体肿大、腺样体肥大、合并过敏性疾病和血红蛋白、白蛋白、维生素A、维生素D、铁离子和锌离子水平仍然是RRTI发病的独立危险因素(P<0.05)。结论小儿RRTI发病受多种因素影响,临床医生在常规治疗过程中,应该注意对其中可控的危险因素进行纠正,以期减少RRTI发生。

Objective To retrospectively analyze the risk factors of recurrent respiratory tract infection(RRTI)in children,in order to provide theoretical basis for clinical prevention.Methods We retrospectively collected 567 children with respiratory tract infection admitted to hospitals in the region from 2016 to 2022,including 138 cases who met the RRTI diagnostic criteria as the study group,and the other 429 cases who did not meet the RRTI diagnostic criteria as the control group.The enrolled children were investigated through self-designed questionnaires,including general conditions,birth conditions,feeding conditions,past medical history,treatment conditions and related nutritional status indicators.The collected data were statistically analyzed to screen the risk factors leading to RRTI in children.Results The univariate analysis showed that the proportion of premature delivery,cesarean section,non-breast-feeding,passive smoking,tonsillar enlargement,adenoid enlargement and allergic diseases in the study group was significantly higher than that in the control group(P<0.05).The levels of hemoglobin,albumin,vitamin A,vitamin D,calcium ion,iron ion and zinc ion in the study group were significantly lower than those in the control group(P<0.05).Multivariate analysis showed that premature delivery,non-breast-feeding,passive smoking,tonsillar enlargement,adenoid enlargement,concomitant allergic diseases and hemoglobin,albumin,vitamin A,vitamin D,iron and zinc levels were still independent risk factors for RRTI(P<0.05).Conclusion The incidence of RRTI in children is affected by many factors.Clinicians should pay attention to correct the controllable risk factors in the routine treatment process in order to reduce the incidence of RRTI.