婴幼儿重度毛细支气管炎及其后反复喘息发作的相关因素研究

Study on related factors of bronchiolitis and subsequent recurrent wheezing in infants

目的:探讨毛细支气管炎严重程度及其与反复喘息发作的相关因素。方法:对104例毛细支气管炎患儿的临床资料进行统计学分析,包括年龄、性别、产重、喂养方式、发病季节、居住环境、肥胖、疾病轻重、哮喘家族史、湿疹史、过敏原、嗜酸细胞百分比、出院后治疗等,采用Logistic逐步回归分析重度毛细支气管炎及反复喘息发作的相关因素。结果:重度毛细支气管炎与年龄、出生体重、先天性心脏病、居住环境的OR值分别为0.740、0.502、15.04、5.25(P<0.05);104例毛支后反复喘息者34例,占32.6%;而重度、哮喘家族史、湿疹、周岁内反复下呼吸道感染、嗜酸细胞增多是毛支后反复喘息发作的相关危险因素,其OR值分别为7.578、106.203、5.712、10.013、50.203(P<0.05)。结论:发病年龄小、低出生体重、合并先天性心脏病、居住环境复杂是重度毛细支气管炎的相关危险因素;重度、哮喘家族史、湿疹、反复下呼吸道感染、嗜酸细胞增多是毛细支气管炎后反复喘息发作的相关危险因素,而出院后口服顺尔宁是保护因素。

Objective： To explore the severity of bronchiolitis and its relationship with subsequent recurrent wheezing in infants.Methods： The clinical data of 104 infants with bronchiolitis were analyzed statistically,including age,gender,birth weight,feeding patterns,season of onset,living environment,obesity,severity of the disease,family history of asthma,medical history of eczema,allergen,eosinophil percentage,treatment after discharge. Logistic stepwise regression analysis was used to analyze the related factors of bronchiolitis and subsequent recurrent wheezing in infants. Results： OR values of severe bronchiolitis and age,birth weight,congenital heart disease,living environment were 0. 740,0. 502,15. 04,5. 25,respectively（ P〈0. 05）; among 104 infants,34 infants were diagnosed as bronchiolitis and subsequent recurrent wheezing,accounting for 32. 6%; severe bronchiolitis,family history of asthma,medical history of eczema,recurrent lower respiratory tract infection within one year after birth,high eosinophil percentage were related risk factors of subsequent recurrent wheezing in infants with bronchiolitis,OR values were 7. 578,106. 203,5. 712,10. 013,50. 203,respectively（ P〈0. 05）. Conclusion：Young age,low birth weight,combing with congenital heart disease,complex living environment are related risk factors of severe bronchiolitis in infants. Severe bronchiolitis,family history of asthma,medical history of eczema,recurrent lower respiratory tract infection within one year after birth,high eosinophil percentage are related risk factors of subsequent recurrent wheezing in infants with bronchiolitis,oral administration of Montelukast is one protective factor.