玉环海岛地区儿童呼吸道感染相关因素的临床研究
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摘要
目的研究维生素A、维生素E水平与儿童呼吸道感染的相关性,分析玉环海岛地区儿童反复呼吸道感染(recurrent respiratory tract infection,RRTI)的相关危险因素。方法将2017年8月—2018年4月在玉环市人民医院住院或门诊就诊的452例儿童分为RRTI组142例,支气管肺炎组158例,健康体检组152例。比较3组维生素A、维生素E缺乏率、贫血率;比较3组维生素A、维生素E和血红蛋白水平差别;将RRTI进行单因素及多因素Logistic回归分析。结果 RRTI组维生素A缺乏率较支气管肺炎组及健康体检组显著升高(均P<0.05),支气管肺炎组维生素A缺乏率较健康体检组显著升高(P<0.05)。3组维生素E缺乏率比较差异无统计学意义(均P>0.05)。RRTI组贫血率较健康体检组显著升高(P=0.002)。3组维生素A、血红蛋白水平比较差异有统计学意义(均P<0.05),3组维生素E水平比较差异无统计学意义(P>0.05)。单因素分析的基础上进行多因素Logistic回归分析显示维生素A缺乏、被动吸烟、早产、贫血、经常输液及幼托为RRTI的独立危险因素(均P<0.05),母乳喂养为独立保护因素(P<0.05)。结论玉环海岛地区儿童维生素A缺乏率较高,维生素E缺乏不明显;儿童RRTI与多种因素有关,其中维生素A缺乏是一个重要原因。
Objective To study the correlation between vitamin A and E levels and respiratory tract infection in children, and to analyze the risk factors of recurrent respiratory tract infection(RRTI) in children in island area of Yuhuan. Methods A total of 452 hospitalized and outpatient children in Yuhuan people's Hospital from August 2017 to April 2018 were divided into RRTI group(142 cases), bronchopneumonia group(158 cases) and healthy physical examination group(152 cases). The rates of vitamin A, vitamin E deficiency and anemia were compared among the three groups. The differences of vitamin A, vitamin E and hemoglobin levels between the three groups were compared. RRTI was analyzed by univariate and multivariate Logistic regression analysis. Results The vitamin A deficiency rate in RRTI group was significantly higher than that in bronchopneumonia group and healthy physical examination group(P<0.05), and the vitamin A deficiency rate in bronchopneumonia group was higher than that in healthy physical examination group(P<0.05). There was no significant difference in vitamin E deficiency rate among the three groups(P>0.05). The anemia rate in the RRTI group was significantly higher than that in the health examination group(P=0.002). There were significant differences in vitamin A and hemoglobin levels among the three groups(P<0.05), but there was no significant difference in vitamin E levels among the three groups(P>0.05). Multivariate Logistic regression analysis based on univariate analysis showed that vitamin A deficiency, passive smoking, premature delivery, anemia, frequent infusion and nursery school were all independent risk factors for RRTI(P<0.05), and breast feeding was an independent protective factor(P<0.05). Conclusion The rate of vitamin A deficiency was higher and vitamin E deficiency was not obvious in children in the island area of Yuhuan, and RRTI in children was related to many factors, among which vitamin A deficiency was an important reason.
Objective To study the correlation between vitamin A and E levels and respiratory tract infection in children, and to analyze the risk factors of recurrent respiratory tract infection(RRTI) in children in island area of Yuhuan. Methods A total of 452 hospitalized and outpatient children in Yuhuan people's Hospital from August 2017 to April 2018 were divided into RRTI group(142 cases), bronchopneumonia group(158 cases) and healthy physical examination group(152 cases). The rates of vitamin A, vitamin E deficiency and anemia were compared among the three groups. The differences of vitamin A, vitamin E and hemoglobin levels between the three groups were compared. RRTI was analyzed by univariate and multivariate Logistic regression analysis. Results The vitamin A deficiency rate in RRTI group was significantly higher than that in bronchopneumonia group and healthy physical examination group(P<0.05), and the vitamin A deficiency rate in bronchopneumonia group was higher than that in healthy physical examination group(P<0.05). There was no significant difference in vitamin E deficiency rate among the three groups(P>0.05). The anemia rate in the RRTI group was significantly higher than that in the health examination group(P=0.002). There were significant differences in vitamin A and hemoglobin levels among the three groups(P<0.05), but there was no significant difference in vitamin E levels among the three groups(P>0.05). Multivariate Logistic regression analysis based on univariate analysis showed that vitamin A deficiency, passive smoking, premature delivery, anemia, frequent infusion and nursery school were all independent risk factors for RRTI(P<0.05), and breast feeding was an independent protective factor(P<0.05). Conclusion The rate of vitamin A deficiency was higher and vitamin E deficiency was not obvious in children in the island area of Yuhuan, and RRTI in children was related to many factors, among which vitamin A deficiency was an important reason.
引文
[1] 丁媛慧,孙中厚,张海美,等.儿童边缘型维生素A缺乏与呼吸道感染相关性及危险因素分析[J].中国儿童保健杂志,2016,24(4):393-395.
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[4] 中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童社区获得性肺炎管理指南(2013修订)(上)[J].中华儿科杂志,2013,51(10):745-752.
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[8] 张振洪,倪明,胡媛.东莞市学龄前儿童维生素A缺乏现状及维生素A对血清铁蛋白及红细胞参数的影响[J].中国当代儿科杂志,2018,20(3):195-199.
[9] 张海美,孙中厚,丁媛慧,等.不同年龄反复呼吸道感染儿童血清维生素A、E水平测定及其临床意义[J].中国儿童保健杂志,2017,25(6):595-597.
[10] 李延琪,杨拴盈. 维生素A 水平与儿童呼吸道感染性疾病的相关性研究[J].吉林医学,2018,39(1):3-5.
[11] 蒋华英,金春华.维生素A与儿童反复呼吸道感染关系的研究进展[J].中国医药,2017,12(1):146-149.
[12] 石正英,管建宏,施益农.儿童反复呼吸道感染72例致病因素分析[J].临床肺科杂志,2017,22(9):1711-1713.
[13] 吴佩琼,侯俏珍,黄俪锋,等.儿童反复呼吸道感染部分相关影响因素分析[J].国际儿科学杂志,2015,42(4):450-453.
[14] 金春华,王晓燕,张丽丽,等.儿童维生素A缺乏与血红蛋白水平及呼吸道感染相关性研究[J].临床儿科杂志,2017,35(10):755-758.
[15] SIMONS E,TO T,MOINEDDIN R,et al.Maternal second-hand smoke exposure in pregnancy is associated with childhood asthma development[J].J Allergy Clin Immunol Pract,2014,2(2):201-207.
[16] 郭平,姚欢迎.小儿营养性缺铁性贫血的相关因素分析[J].中华全科医学,2018,16(2):257-259,295.
[2] SPINAS E,SAGGINI A,KRITAS S K,et al.Can vitamin a mediate immunity and inflammation?[J].J Biol Regul Homeost Agents,2015,29(1):1-6.
[3] 陈慧中.儿童反复呼吸道感染判断条件及反复肺炎诊断思路[J].中国实用儿科杂志,2013,28(3):163-165.
[4] 中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童社区获得性肺炎管理指南(2013修订)(上)[J].中华儿科杂志,2013,51(10):745-752.
[5] 胡亚美,江载芳.诸福棠实用儿科学[M].8版.北京:人民卫生出版社,2015:556-572.
[6] 桂永浩.小儿内科学高级教程[M].北京:中华医学电子音像出版社,2016:300-301.
[7] ABOLURIN O O,ADEGBOLA A J,OYELAMI O A,et al.Prevalence of Vitamin A deficiency among under-five children in South-Western Nigeria[J].Niger Postgrad Med J,2018,25(1):13-16.
[8] 张振洪,倪明,胡媛.东莞市学龄前儿童维生素A缺乏现状及维生素A对血清铁蛋白及红细胞参数的影响[J].中国当代儿科杂志,2018,20(3):195-199.
[9] 张海美,孙中厚,丁媛慧,等.不同年龄反复呼吸道感染儿童血清维生素A、E水平测定及其临床意义[J].中国儿童保健杂志,2017,25(6):595-597.
[10] 李延琪,杨拴盈. 维生素A 水平与儿童呼吸道感染性疾病的相关性研究[J].吉林医学,2018,39(1):3-5.
[11] 蒋华英,金春华.维生素A与儿童反复呼吸道感染关系的研究进展[J].中国医药,2017,12(1):146-149.
[12] 石正英,管建宏,施益农.儿童反复呼吸道感染72例致病因素分析[J].临床肺科杂志,2017,22(9):1711-1713.
[13] 吴佩琼,侯俏珍,黄俪锋,等.儿童反复呼吸道感染部分相关影响因素分析[J].国际儿科学杂志,2015,42(4):450-453.
[14] 金春华,王晓燕,张丽丽,等.儿童维生素A缺乏与血红蛋白水平及呼吸道感染相关性研究[J].临床儿科杂志,2017,35(10):755-758.
[15] SIMONS E,TO T,MOINEDDIN R,et al.Maternal second-hand smoke exposure in pregnancy is associated with childhood asthma development[J].J Allergy Clin Immunol Pract,2014,2(2):201-207.
[16] 郭平,姚欢迎.小儿营养性缺铁性贫血的相关因素分析[J].中华全科医学,2018,16(2):257-259,295.