不同年龄小儿支气管哮喘临床特征及其并发呼吸道感染的危险因素分析

Clinical Characteristics of Bronchial Asthma in Children of Different Ages and Analysis of Risk Factors for Concurrent Respiratory Infections

目的:探讨不同年龄小儿支气管哮喘临床特征及其并发呼吸道感染的危险因素。方法:选取我院2018年1月到2023年1月收治的256例支气管哮喘患儿进行研究,依照患儿年龄进行分组,将年龄<5岁的128例患儿分为低龄组,将年龄≥5岁的128例患儿分为高龄组,对比两组患儿临床症状和疾病严重程度,吸入性过敏原检测结果。随后将256例支气管哮喘患儿依照是否并发呼吸道感染情况分为两个亚组,即呼吸道感染组(n=100)与非呼吸道感染组(n=156),分析其一般临床情况,并采用logistics回归模型分析小儿支气管哮喘并发呼吸道感染的独立影响因素。结果:低龄组和高龄组患儿喘息、肺部哮鸣音症状、疾病严重程度为轻度和中度的比率对比无明显差异(P>0.05),低龄组患儿喘息、气促、咳嗽症状发生率和疾病严重程度为重度的比率明显高于高龄组(P<0.05);低龄组和高龄组患儿大豆、鱼虾类过敏率对比无明显差异(P>0.05),低龄组患儿牛奶、霉菌、花草过敏率低于高龄组,低龄组患儿动物皮毛、户尘螨或粉尘螨过敏率高于高龄组(P<0.05);呼吸道感染组与非呼吸道感染组患儿性别、病程对比无明显差异(P>0.05),呼吸道感染组与非呼吸道感染组患儿年龄、每半年发作次数、发病季节、静脉应用糖皮质激素、血清总Ig E、EOS计数水平对比差异显著(P<0.05);logistic回归分析结果表明:每半年发作次数≥3次、发病季节为秋冬季、静脉应用糖皮质激素、血清总Ig E<100IU/mL、EOS计数≥0.52×10^(9)/L为小儿支气管哮喘并发呼吸道感染的独立危险因素(P<0.05)。结论:不同年龄小儿支气管哮喘临床症状、病情严重程度、过敏原分布情况具有一定差异,且每半年发作次数≥3次、发病季节为秋冬季、静脉应用糖皮质激素、血清总Ig E<100IU/mL、EOS计数≥0.52×10^(9)/L为小儿支气管哮喘并发呼吸道感染的独立危险因素,针对此类患儿在哮喘急性发作期需采取相关措施预防呼吸道感染的发生。

Objective:To explore the clinical characteristics of bronchial asthma in children of different ages and its risk factors for concurrent respiratory infections.Method:A study was conducted on 256 children with bronchial asthma admitted to our hospital from January 2018 to January 2023.They were grouped according to their age.128 children aged<5 years were divided into a younger group,and 128 children aged≥5 years were divided into an older group.The clinical symptoms,disease severity,and inhalation allergen test results of the two groups of children were compared.Subsequently,256 children with bronchial asthma were divided into two subgroups based on whether they were complicated with respiratory infections,namely the respiratory infection group(n=100)and the non respiratory infection group(n=156).Their general clinical situation was analyzed,and the independent influencing factors of respiratory infections in children with bronchial asthma were analyzed using a logistic regression model.Result:There was no significant difference in the incidence of wheeze,lung wheezing symptoms,and disease severity between the younger and older groups(P>0.05).The incidence of wheezing,shortness of breath,cough symptoms,and disease severity in the younger group was significantly higher than that in the older group(P<0.05);There was no significant difference in the allergenic rates of soybeans,fish,and shrimp between the younger and older groups(P>0.05).The allergenic rates of milk and mold in the younger group were lower than those in the older group,while the allergenic rates of animal fur,dust mites,or dust mites in the younger group were higher than those in the older group(P<0.05);There was no significant difference in gender and course of disease between the respiratory infection group and the non respiratory infection group(P>0.05).However,there were significant differences in age,frequency of seizures every six months,onset season,intravenous corticosteroids,total serum IgE,and EOS count between the respiratory infection group and the non respiratory infection group(P<0.05);The results of logistic regression analysis showed that the number of episodes per six months was≥3,the onset season Table 1 Comparison of clinical symptoms and disease severity of children with bronchial asthma of different ages(n,%)was autumn and winter,intravenous corticosteroids were injected,total serum IgE<100 IU/mL,and EOS count≥0.52×10^(9)/L is an independent risk factor for respiratory tract infection in children with bronchial asthma(P<0.05).Conclusion:There are certain differences in clinical symptoms,severity,and allergen distribution of bronchial asthma in children of different ages,with≥3 episodes every six months,onset season in autumn and winter,intravenous corticosteroids,serum total IgE<100IU/mL,and EOS count≥0.52×10^(9)/L is an independent risk factor for respiratory tract infection in children with bronchial asthma.Relevant measures should be taken to prevent the occurrence of respiratory tract infection in such children during the acute onset of asthma.