下呼吸道感染危险因素的病例对照研究

Case-control study on risk factors of lower respiratory tract infection

目的探讨医院下呼吸道感染的危险因素。方法对2010—2012年的住院患者进行回顾性研究,309例发生下呼吸道感染患者为病例组,未感染者根据住院科室相同、入院日期相近(±10 d)的配比条件按1∶1作为对照组,采用单因素分析和多因素Cox回归分析下呼吸道感染的危险因素,P<0.05为差异有统计学意义。结果对患者方面可能的危险因素进行单因素分析,年龄(OR=1.536,95%CI为1.204~1.959),入院情况为急(OR=2.356,95%CI为1.588~3.495)、重(OR=4.050,95%CI为2.387~6.871)、危(OR=3.280,95%CI为2.038~5.279),低蛋白血症(OR=1.973,95%CI为1.496~2.602),昏迷时间(OR=1.966,95%CI为1.478~2.616),出院诊断的疾病种类(OR=4.553,95%CI为2.863~7.243),住院最高体温(OR=1.336,95%CI为1.223~1.449),白细胞数(OR=1.511,95%CI为1.205~1.895),基础疾病严重程度为严重(OR=3.719,95%CI为2.349~5.888)、危重(OR=4.021,95%CI为2.375~6.810),高血压(OR=1.357,95%CI为1.084~1.697),脑血管意外(OR=1.486,95%CI为1.188~1.859),脏器衰竭(OR=1.449,95%CI为1.043~2.013)等11个因素会增加下呼吸道感染的危险性,差异均有统计学意义(均P<0.05);再对这11个变量进行Cox回归分析,结果表明基础疾病严重程度(OR=1.682,95%CI为1.417~1.997)、出院诊断的疾病种类(OR=2.412,95%CI为1.474~3.950)和住院最高体温(OR=1.204,95%CI为1.081~1.341)是下呼吸道感染的独立危险因素。结论控制医院下呼吸道感染,应针对危险因素,采取相应的预防措施,从而控制和减少感染的发生。

Objective To discuss the risk factors of lower respiratory tract infection.Methods A retrospective study was carried out on hospitalized patients from Jan 2010 to Dec 2012.309 cases of lower respiratory infection were chosen as case group,while 309 non-infective cases who were treated in the same department and admitted almost at the same time（ ± 10 d）were selected as control group.The risk factors were studied by means of both single factor and muhifactor Cox regression analysis,P〈0.05 was considered to be significantly different.Results Single factor analysis was conducted on possible risk factors,and the results showed that there were eleven factors that might increase the risk of lower respiratory tract infection,including agc（OR=1.536,95% CI 1.204-1.959）;conditions on admission with urgent （OR=2.356,95% CI 1.588-3.495）,severity （OR=4.050,95% CI 2.387-6.871）; hypoproteinemia （OR=1.973,95%CI 1.496-2.602）;the duration of coma （OR=1.966,95%CI f.478-2.616）;diagnosis on discharge （0R=4,553,95%CI 2.863-7.243）;the highest body temperature after admission（OR=l.336,95%Cl 1.223-1.449）;WBC count（OR= 1.511,95%CI 1.205-1.895）;the severity of underlying disease with severity（OR^3.719,95%CI 2.349-5.888）,critical condition（OR= 4.021,95% CI 2.375-6.81）;hypertension （0R=1.357,95% CI 1.084-1.697）;stroke （OR=1.486,95% CI 1.188-1.859）;organ failure （OR=1.449,95%CI 1.043-2.013）,there were significant differences（all P〈0.05）.Cox regression analysis of the 11 variables indicat- ed that the severity of underlying disease（OR--1.682,95%Cl 1.417-1.997）,diagnosis on discharge（OR=2.412,95%Cl 1.474-3.950） and the highest temperature on adimission（OR=l.204,95%Cl 1.081-1.341）were the independent risk factors.Conclusion Con- trol of lower respiratory infection should focus on risk factors,so that appropriate preventive measures should be taken to reduce the occurrence of lower respiratory infection.