支气管哮喘患儿感染病原体的种类及相关危险因素分析

Distribution of pathogens and related risk factors in children with bronchial asthma

目的探究支气管哮喘门诊患儿合并感染病原体的分布及其相关危险因素。方法以2017年1月-2018年1月在北京世纪坛医院因支气管哮喘合并感染在门诊就诊的患儿120例作为观察对象,以同期就诊的单纯支气管哮喘患者作为对照组,采用间接荧光免疫法检测呼吸道9项病原体(病毒、细菌、立克次体、支原体和衣原体)抗体,通过VETEKⅡ质谱分析对细菌进行鉴定;采用Logistic回归分析支气管哮喘合并感染的危险因素。结果检测的呼吸道病毒中,呼吸道合胞病毒和副流感病毒的检出率较高,分别为35.83%和23.33%;细菌感染以肺炎克雷伯菌和肺炎链球菌检出率较高,分别为5.00%和2.50%;真菌感染主要是白色假丝酵母菌和克柔假丝酵母菌,检出率分别为2.50%和0.83%。Logistic回归分析发现哮喘发作次数、鼻部结构异常、家里养动物和住院史是支气管哮喘合并感染的危险因素。结论支气管哮喘合并感染的病原体主要是病毒,其次为细菌和真菌;哮喘发作次数、鼻部结构异常、家里养动物和住院史是感染的重要危险因素。

Objective To investigate the distribution and related risk factors of pathogens in children with bronchial asthma. Methods From January 2017 to January 2018,120 bronchial asthma children complicated with respiratory tract infection in the outpatient department of Beijing Shijitan Hospital were enrolled in this study. The cases with bronchial asthma only at the same time were enrolled as the control group. The antibody of 9 kinds of pathogen in-cluding virus,bacteria,Rickettsia,Mycoplasma and Chlamydia were detect from the respiratory tract samples by using Indirect fluorescent immunoassay(IFA),and the bacteria were identified by VETEK Ⅱ. The Logistic regression was used to analyze the risk factors of bronchial asthma complicated with infection. Results The detection rate of respiratory syncytial virus and parainfluenza virus were higher(35.83% and 23.33%) in the respiratory viruses. Klebsiella pneumoniae and Streptococcus pneumonia were the important pathogens with the detection rate of 5.00% and 2.50%.The fungal infections were mainly Candida albicans and Candida krusei,and the detection rate was 2.50% and 0.83%,respectively. Logistic regression analysis found that the number of asthma attacks,nasal structural abnormalities,homeraising animals,and hospitalization history were the risk factors for bronchial asthma complicated with infection. Conclusion The pathogens of bronchial asthma complicated with respiratory tract infection were mainly viruses,followed by bacteria and fungi. The number of asthma attacks,nasal structural abnormalities,domestic animal feeding and hospitalization history were important risk factors for the infection.