儿童反复呼吸道感染的危险因素及维生素D的干预作用研究
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摘要
目的 :探讨儿童反复呼吸道感染的危险因素和采用维生素D进行干预的预防效果。方法 :选取2016年3月～2017年3月该院儿科的反复呼吸道感染的儿童152例作为主要观察对象(观察组),选择同期来该院进行常规体检的儿童152例作为对照组,通过对患儿的一般情况(性别、年龄、母乳喂养情况、饮食情况、吸二手烟、户外活动、滥用抗生素治疗)进行单因素分析,并进行Logistic回归分析,以确定儿童反复呼吸道感染的相关因素;并将观察组患儿采用完全随机方式将患儿分为实验组(76例)和对比组(76例),实验组增加维生素D进行干预,对比组不加干预,对患儿跟踪随访1年,对比2组患儿不同时间段的呼吸道感染复发情况。结果 :经单因素及多因素回归分析,儿童反复呼吸道感染的危险因素主要为户外活动、挑食、滥用抗生素,母乳喂养是其保护因素;实验组在3个月时的复发率与对照组无显著差异;实验组在干预后6个月及1年的复发率均显著低于对照组。结论 :鼓励儿童增加户外活动时间(2小时以上)、均衡营养、避免营养不良、减少抗生素使用量是能够避免发生反复呼吸道感染,患儿可以在正规治疗的前提下,通过补充维生素D的方式降低呼吸道感染的发病率,值得临床推广。
Objective To explore the risk factors of recurrent respiratory tract infection in children and the preventive effect of vitamin D intervention. Methods 152 pediatric children with recurrent respiratory tract infection from March 2016 to March2017 were selected as the main observation objects.152 children who underwent routine physical examination in the same period were selected as the control group. The general conditions(sex, age, breast-feeding, diet, secondhand smoke, outdoor activities) of the children were compared. Single factor analysis and Logistic regression analysis were performed to determine the related factors of recurrent respiratory tract infection in children. The children in the observation group were randomly divided into experimental group(n=76) and control group(n=76). The experimental group was treated with vitamin D, and the control groupwas followed up for 1 year. The recurrence of respiratory tract infection was compared in two groups. Results By univariate and multivariate regression analysis, the risk factors of recurrent respiratory tract infection in children were mainly outdoor activities, picky food, abuse of antibiotics; and breast feeding were the protective factors. There was no significant difference in the recurrence rate between the experimental group and the control group at 3 months, but the recurrence rate in the experimental group at 6 months and 1 year after intervention was significantly lower than that in the control group. Conclusion Encourage children to increase outdoor activity time(more than 2 hours), balance nutrition, avoid malnutrition, reduce the use amount of antibiotics, reduce the incidence of respiratory tract infection by supplementing vitamin D, and deserve clinical popularization.
Objective To explore the risk factors of recurrent respiratory tract infection in children and the preventive effect of vitamin D intervention. Methods 152 pediatric children with recurrent respiratory tract infection from March 2016 to March2017 were selected as the main observation objects.152 children who underwent routine physical examination in the same period were selected as the control group. The general conditions(sex, age, breast-feeding, diet, secondhand smoke, outdoor activities) of the children were compared. Single factor analysis and Logistic regression analysis were performed to determine the related factors of recurrent respiratory tract infection in children. The children in the observation group were randomly divided into experimental group(n=76) and control group(n=76). The experimental group was treated with vitamin D, and the control groupwas followed up for 1 year. The recurrence of respiratory tract infection was compared in two groups. Results By univariate and multivariate regression analysis, the risk factors of recurrent respiratory tract infection in children were mainly outdoor activities, picky food, abuse of antibiotics; and breast feeding were the protective factors. There was no significant difference in the recurrence rate between the experimental group and the control group at 3 months, but the recurrence rate in the experimental group at 6 months and 1 year after intervention was significantly lower than that in the control group. Conclusion Encourage children to increase outdoor activity time(more than 2 hours), balance nutrition, avoid malnutrition, reduce the use amount of antibiotics, reduce the incidence of respiratory tract infection by supplementing vitamin D, and deserve clinical popularization.
引文
[1]胡丹.对新生儿呼吸道感染者采用中西医结合方式治疗的效果观察[J].湖南师范大学学报(医学版), 2017, 14(01):133-135.
[2]田勇,白永莲,刘曌霞.3岁内儿童维生素D缺乏性佝偻病的影响因素[J].湖南师范大学学报(医学版), 2017, 14(04):71-75.
[3]杨海红,刘艳,罗列芳.婴幼儿期反复呼吸道感染与维生素D缺乏性佝偻病的关系研究[J].吉林医学, 2016, 37(08):1978-1980.
[4]林立,李昌崇.儿童反复呼吸道感染判断条件和防治[J].中华实用儿科临床杂志, 2017, 32(4):249-252.
[5]中国医师协会儿科医师分会儿童耳鼻咽喉专业委员会,许政敏,付勇,等.儿童反复上呼吸道感染临床诊治管理专家共识[J].中国实用儿科杂志, 2017(10):721-725.
[6]张海军,董晓蕾.儿童肺炎支原体肺炎治愈1年内反复呼吸道感染的发生情况及其相关因素分析[J].山东医药, 2017, 57(22):56-58.
[7]方国兴,胡国华.维生素D联合布拉氏酵母菌治疗小儿反复呼吸道感染的临床疗效研究[J].中国全科医学, 2017, 20(34):4284-4288.
[8]方智,任翼,石霖.维生素D对患儿RRI的血清25-(OH)D3、免疫球蛋白水平变化分析[J].中国地方病防治杂志, 2017(4):443-443.
[9]敖李,徐秋.蒲地蓝消炎口服液治疗儿童急性上呼吸道感染的临床观察[J].中国药房, 2018(3):390-393.
[10]李文敏,卢雅玲,李文惠.儿童上呼吸道感染抗生素使用率的meta分析[J].中国卫生统计, 2017, 34(4):625-628.
[11]袁翊,陈文碧,刘靳波,等.儿童下呼吸道临床分离菌的分布及耐药性[J].中国感染与化疗杂志, 2017, 17(5):552-557.
[12]王扬帆,蔡坤,黄转,等.儿童呼吸道肺炎链球菌感染的耐药性及危险因素分析[J].中华医院感染学杂志, 2017, 27(7):1623-1626.
[13]刘玉芹.临床儿科细菌性呼吸道感染采用药物治疗的临床分析[J].中国社区医师, 2018(2):81-81.
[14]李传景,王新宇,时鼎,等.匹多莫德联合玉屏风口服液在小儿反复呼吸道感染患者中的临床效果及对肺功能的影响研究[J].中华医院感染学杂志, 2018(2):280-283.
[2]田勇,白永莲,刘曌霞.3岁内儿童维生素D缺乏性佝偻病的影响因素[J].湖南师范大学学报(医学版), 2017, 14(04):71-75.
[3]杨海红,刘艳,罗列芳.婴幼儿期反复呼吸道感染与维生素D缺乏性佝偻病的关系研究[J].吉林医学, 2016, 37(08):1978-1980.
[4]林立,李昌崇.儿童反复呼吸道感染判断条件和防治[J].中华实用儿科临床杂志, 2017, 32(4):249-252.
[5]中国医师协会儿科医师分会儿童耳鼻咽喉专业委员会,许政敏,付勇,等.儿童反复上呼吸道感染临床诊治管理专家共识[J].中国实用儿科杂志, 2017(10):721-725.
[6]张海军,董晓蕾.儿童肺炎支原体肺炎治愈1年内反复呼吸道感染的发生情况及其相关因素分析[J].山东医药, 2017, 57(22):56-58.
[7]方国兴,胡国华.维生素D联合布拉氏酵母菌治疗小儿反复呼吸道感染的临床疗效研究[J].中国全科医学, 2017, 20(34):4284-4288.
[8]方智,任翼,石霖.维生素D对患儿RRI的血清25-(OH)D3、免疫球蛋白水平变化分析[J].中国地方病防治杂志, 2017(4):443-443.
[9]敖李,徐秋.蒲地蓝消炎口服液治疗儿童急性上呼吸道感染的临床观察[J].中国药房, 2018(3):390-393.
[10]李文敏,卢雅玲,李文惠.儿童上呼吸道感染抗生素使用率的meta分析[J].中国卫生统计, 2017, 34(4):625-628.
[11]袁翊,陈文碧,刘靳波,等.儿童下呼吸道临床分离菌的分布及耐药性[J].中国感染与化疗杂志, 2017, 17(5):552-557.
[12]王扬帆,蔡坤,黄转,等.儿童呼吸道肺炎链球菌感染的耐药性及危险因素分析[J].中华医院感染学杂志, 2017, 27(7):1623-1626.
[13]刘玉芹.临床儿科细菌性呼吸道感染采用药物治疗的临床分析[J].中国社区医师, 2018(2):81-81.
[14]李传景,王新宇,时鼎,等.匹多莫德联合玉屏风口服液在小儿反复呼吸道感染患者中的临床效果及对肺功能的影响研究[J].中华医院感染学杂志, 2018(2):280-283.