儿童反复呼吸道感染易感因素的临床研究

Clinical research of susceptibility factors of children with recurrent respiratory infections

目的 探讨儿童反复呼吸道感染的易感因素.方法 选择2011.2-2013.2我院收治呼吸道反复感染患儿（观察组）及门诊体检的健康儿童（对照组）各150例.采用自制的儿童反复呼吸道感染易感因素调查表,记录两组儿童血常规、血金属元素及血免疫球蛋白等检查结果.采用卡方检验和t检验进行易感因素的单因素分析,采用非条件Logistic回归模型进行易感因素的多因素分析.结果 观察组的血钙、铁元素、血IgA和IgG明显低于对照组,具有显著性差异（P〈0.05）.将与儿童反复呼吸道感染相关的因素引入多因素Logistic回归分析,结果显示：胎次≥3次（OR=2.988,95%CI 1.249-5.147）、被动吸烟（OR=6.812,95%CI 2.143-13.764）、低钙血症（OR=3.304,95%CI 1.203-6.056）、血清IgA〈230 mg/L（OR=5.237,95%CI 1.103-10.721）和IgG〈5 g/L（OR=5.408,95%CI 1.282-11.302）、抗生素与激素的使用（OR=8.542,95%CI 3.762-16.997）、生活环境（幼儿园） （OR=3.251,95%CI 1.377-6.223）为儿童反复呼吸道感染的独立易感因素.结论儿童反复呼吸道感染多种因素有关,应针对易感因素做好预防工作.

Objective To explore the susceptibility factors of children with recurrent respiratory infections. Methods 150 children with recurrent respiratory infections were selected as the observation group, and another 150 healthy children were taken as the controls. It used self-designed susceptibility factors questionnaire to record blood routine, blood metallic elements, and blood immunoglobulin examination results. Chi-square test and T test were used to analyze the single factor of the susceptible factors. Logistic regression model was adopted to analyze the muhi- factor of the susceptible factors. Results The levels of blood calcium, ferrum, IgA and IgG were obviously lower in the observation group than in the control group （P 〈 0. 05）, The logistic regression showed that the risk factors of children with recurrent respiratory infections included parity （ X2 = 6. 236, P =- 0. 011 ） , passive smoking （ X2 = 10.542, P=0.005）, blood calcium （X2 =15.442, P=0.000）, IgA （X2 =8.384, P=0.007） and IgG （X2 = 8. 384, P = 0. 007） , use of antibiotics and hormones （ X2 = 20. 553, P = 0. 000） , and living environment （ kinder- garten） （ X2 = 7. 836, P = 0. 008）. Conclusion The predisposing factors of children with repeated respiratory infec tions include parity, passive smoking, blood calcium, IgA and IgG, use of antibiotics and hormones, and living envi ronment （kindergarten）.