婴儿吸入性肺炎危险因素的病例对照研究

Case-control study on risk factors for aspiration pneumonia in infants

目的分析婴儿吸入性肺炎的危险因素。方法纳入2016年1月至2018年12月因肺炎在复旦大学附属儿科医院(我院)住院,入院前在我院门诊或入院后完成唾液吸入显像检查的患儿,根据检查结果分为病例组(吸入性肺炎)和对照组(非吸入性肺炎),回顾性收集临床资料,比较两组临床特征,分析婴儿吸入性肺炎的危险因素。结果484例患儿进入本文分析,病例组151例,对照组333例。两组既往肺炎病史、呛奶、病原学检测阳性、伴有神经系统疾病、上气道疾病、下气道结构异常、遗传综合征差异均具有统计学意义。Logistic回归分析结果显示病原学检测阳性(OR=2.033,95%CI:1.261~3.279)、伴有神经系统疾病(OR=2.210,95%CI:1.318~3.707)、上气道疾病(OR=2.408,95%CI:1.556~3.727)、遗传综合征(OR=2.909,95%CI:1.265~6.692)是婴儿吸入性肺炎的独立危险因素。结论病原学检测阳性、伴有神经系统疾病、上气道疾病、遗传综合征是婴儿吸入性肺炎的危险因素。

Objective To analyze the risk factors of infantile aspiration pneumonia Methods We reviewed hospital patients with pneumonia who completed the salivagram in the clinic or after hospital ization in Children's Hospital of Fudan University in January 2016 to December 2018.The patients were classified into 2 groups according to the test results:case group(aspiration pneumonia group)and control group(non aspiration pneumonia).The clinical features of the two groups were collected and compared to analyze the risk factors of infantile aspiration pneumonia.Results A total of 484 cases were included in this study,including 151 cases in the case group and 333 cases in the control group,with a positive rate of 31.2%.Previous history of pneumonia,milk choking,positive pathogen test,accompanied by neurological disease,upper airway disease,lower airway structural abnormality and genetic syndrome showed significant differences between the 2 groups.Logistic regression analysis showed that positive pathogen test(OR=2.033,95%CI:1.261 3.279),accompanied by neurological disease(OR=2.210,95%CI:1.318 3.707),upper airway disease(OR=2.408,95%CI:1.556 3.727),and genetic syndrome(OR=2.909,95%CI:1.265 6.692)were independent risk factors for aspiration pneumonia in infants Conclusion The risk factors of aspiration pneumonia in infants included positive pathogen test,accompanied by neurological disease,upper airway disease and genetic syndrome.