小儿反复下呼吸道感染发病因素分析

Analysis on Etiological Factors of Recurrent Lower Respiratory Tract Infection in Children

目的对诱发小儿反复下呼吸道感染的因素进行分析。方法选取2011年1月至2012年9月在深圳市儿童医院就诊的反复下呼吸道感染患儿47例作为观察组,同期进行健康体检的46例正常儿童作为对照组,根据调查表详细记录所有研究对象的一般临床资料,并测定血液中铁、锌、钙、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)及T细胞亚群CD3+、CD4+及CD4+/CD8+的分类情况。结果与对照组相比,观察组患者血液中CD8+水平显著升高,锌、钙、铁、IgA、IgG、IgM、CD3+、CD4+及CD4+/CD8+水平显著降低(P<0.05),而补体3(C3)和C4水平无明显改变,两组比较差异无统计学意义(P>0.05);两组儿童在是否为早产、母亲生育年龄、居住环境、是否规范治疗及是否为过敏体质方面存在显著差异(P<0.05),在喂养方式方面的差异无统计学意义(P>0.05)。结论小儿反复下呼吸道感染的发病可能与机体中CD8+水平过高,锌、钙、铁、IgA、IgG、IgM、CD3+、CD4+和CD4+/CD8+水平过低有关,并且与患儿早产、母亲生育年龄≥35岁、居住环境、是否进行规范治疗及过敏体质有关。

Objective To analyze the etiological factors of recurrent lower respiratory tract infection in children. Methods A total of 47 children with recurrent lower respiratory tract infection during Jan. 2011 and Sep. 2012 were enrolled into this study in Shenzhen Children＇s Hospital as the observation group. At the same time, a total of 46 healthy children for physical examization were also enrolled into this study as the con- trol group. The clinical data in the study were recorded in detail according to the questionnaire, and zinc, iron, calcium, magnesium,immunoglobulin A （ IgA ）, immunoglobulin G （ IgG ）, immunoglobulin M （ IgM ）, and the T cell subpopulation of all the subjects were tested. Results Compared with the control group, the blood CD8＋ level of the observation group increased significantly, the blood zinc, calcium, iron, IgA, IgG, IgM, CD3^＋ , CD4^＋ and CD4^＋/CD8^＋ level decreased significantly, with significant differenced （ P 〈 0.05 ）. The blood C3 and C4 level were not significantly changed （ P 〉 0.05 ） ; there were differences in premature birth, children-bearing age, living environment, standard treatment, hypersensitivity of the two groups, which were statistically significant （P 〈 0.05 ） ;there was no difference in the feeding manner between the two groups （P 〉 0.05 ）. Conclusion The incidence of recurrent lower respiratory tract infection in children may be corre- lated with the higher levels of CD8^＋ , the lower level of zinc, calcium, iron, IgA, IgG, IgM, CD3 ^＋ , CD4 ^＋ and CD4^＋/CD8^＋ , premature birth, children-bearing age ≥ 35 years, living environment, standard treatment, and hypersensitivity.