小儿喘息性疾病喘息反复发作的病原学及危险因素分析

The Etiology and Pathogenesy in Young Children with Asthmatic Disease

目的:分析小儿喘息性疾病病原学及与喘息发作有关的因素。方法:227例患儿来我院儿科住院的患儿,在有喘息发作及无喘息发作时均取分泌物进行细菌和病毒检测,并对可能与喘息发作有关的因素做统计分析。结果:喘息发作时细菌感染91例(40.1%),病毒感染110例(48.5%),无喘息时72例(31.7%)检出细菌感染,59例(26%)检出病毒感染,喘息发作时细菌和病毒感染检出率均显著高于无喘息时(P<0.05)。单因素分析过敏史、细菌感染、病毒感染、被动吸烟史、家族史和季节等暴露因素在喘息次数超过和低于4次患儿之间存在差异(P<0.05)。多因素非条件Logistic回归分析显示病毒感染(OR=2.839)、细菌感染(OR=2.434)、过敏史(OR=4.412)和家族史(OR=2.158)为喘息性疾病患儿喘息发作次数增多的主要危险因素。结论:病毒和细菌感染为小儿喘息性疾病的主要致病原,病毒和细菌感染、有过敏史与家族史是喘息反复发作的危险因素。

Objective： To analyze and investigate the etiology and pathogenesy of asthmatic disease in young children with Asthm- atic disease. Methods： The secretion trom 227 young children with or without wheezing onset were collected for etiology detection. The multifactor logistic regression analysis was used to analyze the correlation of wheezing onset with investigated factors. Results： The detection rate of bacteria of children with wheezing onset was 40.1%, the detection rate of virus was 48.5 %; while the detection rate of bacteria of children without wheezing onset was 26 %, the detection rate of virus was 31.7 %; there was a significant difference of the rate of infection between patients with and without wheezing onset （P〈0.05）. Single factor analysis of exposure factors including： history of allergy bacterial infection, virus infection passive smoking history family history and the season showed significant difference between wheezing onset over 4 times and under 4 times （P〈0.05）. Multiple regression analysis showed that the main risk factor was significantly correlated with bacteria （OR=2.434）, virus （OR=2.839）, history of allergy （OR=4.412） and family history （OR=2.158）. Conclusion： Bacteria and virus are the main pathogenic agents of asthmatic disease in young children, viruses and bacteria infections, history of allergy, family history are the risk factors of recurrent attacks of wheezing.