3～6岁儿童反复呼吸道感染的多因素分析
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摘要
目的：了解山西省部分3-6岁儿童反复呼吸道感染的影响因素和T淋巴细胞亚群及NK细胞的变化,为防治反复呼吸道感染发生,提高儿童的生活质量,避免临床上过度或不当的治疗,以及制定科学、合理和经济的防治措施而提供理论依据。
方法：严格按照入选标准和剔除标准收集来山西省妇幼保健院儿保科就诊的3-6岁儿童230例,其中：病例组118例,对照组112例。采用病例对照研究。对研究对象通过问卷调查,收集儿童的一般人口学特征、营养状况、父母育儿方式、家庭环境等情况。用流式细胞仪对病例组和对照组分别进行T细胞亚群、NK细胞的检测。使用SPSS13.0统计软件建立数据库并进行分析：t检验、χ2检验对两组进行均衡性检验；应用非条件Logistic回归对反复呼吸道感染的影响因素进行分析；对两组T细胞亚群进行Wilcoxon秩和检验,NK细胞进行t'检验。
结果：
1、病例组和对照组性别(χ2=1.584,P=0.208),年龄(t=1.650,P=0.100),体重(t=0.341,P=0.733),身高(t=0.124,P=0.902)差异均无统计学意义(P>0.05)。
2、反复呼吸道感染的影响因素：①危险因素包括：每周摄入蔬菜1-3次(OR=5.195,95%CI(1.193,22.624)),入托(OR=5.642,95%CI(1.149,27.702)),入托前有反复呼吸道感染病史(OR=8.129,95%CI(2.725,24.256)),每日户外活动不足2小时(OR=5.291,95%CI(1.576,17.763))；②保护因素包括：父亲教育程度在高中以上(OR=0.134,95%CI(0.034,0.527)),每周摄入水果4-6次(OR=0.231,95%CI(0.069,0.775)),年使用抗生素低于3次[OR=0.028,95%CI(0.003,0.303))
3、对T细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)进行两独立样本的Wilcoxon秩和检验,结果表明：CD3+(Z=-1.588,P=0.112),CD4+(Z=-0.541,P=0.588),CD8+(Z=-0.733,P=0.463),CD4+/CD8+(Z=-0.315,P=0.753)病例组和对照组差异均无统计学意义。
4、对NK细胞(CD3-CD16+CD56+)进行t'检验(t'=2.779,P=0.006,95%CI(0.674,4.003)),病例组低于对照组,差别有统计学意义(P<0.05)。
结论：
1、对3-6岁反复呼吸道感染儿童的多因素分析结果提示,以下因素可能对儿童反复呼吸道感染有保护作用。
①平衡膳食,保证动物性食物、蔬菜和水果的摄入；
②合理安排户外活动时间；
③提高家长文化程度(尤其是父亲)；
④托幼机构应该加强卫生保健工作,做好在园(所)儿童的晨、午、晚间检查,发现疾病及时隔离,尽量减少或避免交叉感染的发生
⑤对患呼吸道感染儿童应及时治疗,合理用药,避免滥用抗生素。
2、淋巴细胞检测结果表明：
①在反复呼吸道感染的儿童中,T细胞亚群没有变化,提示在预防用药时,应该合理、慎重使用免疫调节剂,以免不当治疗和增加患者的经济负担；
②在临床上,对于反复呼吸道感染儿童检测NK细胞是有意义的。
Objective To investigate the impact factors on recurrent upper respiratory tract infections(RRTIs) and change of T lymphocytes、NK cell in children aged 3 to 6 years in Shanxi. For enhancing the quality of children life,avoiding unreasonable therapy in order to explore new method for taking prevention measures.
Methods 230 Children aged 3 to 6 years were collected with strict criterion choice and abandoned. The case group had 118 samples, the control group had 112 samples. case-control study was used. one self-administered questionnaire was used to know children'general information, nutrition, the way parents breed children and family environment. The expression of CD3, CD4, CD8 on T cells; CD16 CD56 on NK cells from peripheral blood was evaluated by a flow cytometry method. SPSS13.0 software were used for data analyses:the equilibrium test compared by t-test andχ2 analysis; the impact factors on RRTIs were analyzed by the Logistic regression. The subset of T lymphocytes compared by Wilcoxon rank sum test of two independent samples, NK cell was compared by t'-test.
Results
1、There were no significant difference in sex(χ2=1.584,P=0.208), age(t=1.650, P=0.100), weight(t=0.341,P=0.733), height(t=0.124,P=0.902) between case group and control group(P>0.05). which indicated that the sample can represent the population.
2、The impact factors on RRTIs:①The risk factors:1 to 3 times intake of vegetables every week (OR=5.195,95%CI(1.193,22.624)), kindergartens (OR=5.642,95%CI (1.149,27.702)),RRTIs disease history (OR=8.129,95%CI (2.725,24.256)), and less than outdoor exercise of 2 hours (OR=5.291,95%CI (1.576,17.763))②The protective factors:the level of father education (OR=0.134,95%CI(0.034,0.527)), taking 4 to 6 times fruits every week (OR=0.231,95%CI(0.069,0.775)), lower 3 frequencies using of antibiotics in one year (OR=0.028,95%CI(0.003,0.303))
3、The subset of T lymphocytes compared by Wilcoxon rank sum test of two independent samples, we concluded that there were no statistically significant difference for all comparisons. CD3+(Z=-1.588, P=0.112), CD4+(Z=-0.541, P=0.588), CD8+(Z=-0.733, P=0.463), CD4+/CD8+(Z=-0.315, P=0.753).
4、There were statistically significant difference in NK cell between two groups. (t'=2.779,P=0.006,95%CI(0.674,4.003))
Conclusions
1、From the conclude of the impact factors:
①Keeping intake of vegetables,fruits, meat.
②Reasonably arrange time of outdoor exercise everyday may decrease the frequencies of
RRTIs.
③It is positive affect for recurrent respiratory tract infections to the higher level of parents'education, especially father.
④Kindergartens should enhance the work of health care. Do examine in morning、noon and evening. Finding the disease'children should be isolation in time. To decrease or avoid the cross-infection.
⑤Respiratory tract infection in children should be therapied in time, and reasonably use the drug, to avoid abusing antibiotic.
2、From the conclude of the lymphocytes:
①For children on RRTIs, T lymphocytes were not change. In prevention, we should reasonable use immunomodulation, to avoid generating a great economic impact.
②In the clinic, flow cytometric analysis of the subset of NK cell is a useful means for RRTIs.
方法：严格按照入选标准和剔除标准收集来山西省妇幼保健院儿保科就诊的3-6岁儿童230例,其中：病例组118例,对照组112例。采用病例对照研究。对研究对象通过问卷调查,收集儿童的一般人口学特征、营养状况、父母育儿方式、家庭环境等情况。用流式细胞仪对病例组和对照组分别进行T细胞亚群、NK细胞的检测。使用SPSS13.0统计软件建立数据库并进行分析：t检验、χ2检验对两组进行均衡性检验；应用非条件Logistic回归对反复呼吸道感染的影响因素进行分析；对两组T细胞亚群进行Wilcoxon秩和检验,NK细胞进行t'检验。
结果：
1、病例组和对照组性别(χ2=1.584,P=0.208),年龄(t=1.650,P=0.100),体重(t=0.341,P=0.733),身高(t=0.124,P=0.902)差异均无统计学意义(P>0.05)。
2、反复呼吸道感染的影响因素：①危险因素包括：每周摄入蔬菜1-3次(OR=5.195,95%CI(1.193,22.624)),入托(OR=5.642,95%CI(1.149,27.702)),入托前有反复呼吸道感染病史(OR=8.129,95%CI(2.725,24.256)),每日户外活动不足2小时(OR=5.291,95%CI(1.576,17.763))；②保护因素包括：父亲教育程度在高中以上(OR=0.134,95%CI(0.034,0.527)),每周摄入水果4-6次(OR=0.231,95%CI(0.069,0.775)),年使用抗生素低于3次[OR=0.028,95%CI(0.003,0.303))
3、对T细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)进行两独立样本的Wilcoxon秩和检验,结果表明：CD3+(Z=-1.588,P=0.112),CD4+(Z=-0.541,P=0.588),CD8+(Z=-0.733,P=0.463),CD4+/CD8+(Z=-0.315,P=0.753)病例组和对照组差异均无统计学意义。
4、对NK细胞(CD3-CD16+CD56+)进行t'检验(t'=2.779,P=0.006,95%CI(0.674,4.003)),病例组低于对照组,差别有统计学意义(P<0.05)。
结论：
1、对3-6岁反复呼吸道感染儿童的多因素分析结果提示,以下因素可能对儿童反复呼吸道感染有保护作用。
①平衡膳食,保证动物性食物、蔬菜和水果的摄入；
②合理安排户外活动时间；
③提高家长文化程度(尤其是父亲)；
④托幼机构应该加强卫生保健工作,做好在园(所)儿童的晨、午、晚间检查,发现疾病及时隔离,尽量减少或避免交叉感染的发生
⑤对患呼吸道感染儿童应及时治疗,合理用药,避免滥用抗生素。
2、淋巴细胞检测结果表明：
①在反复呼吸道感染的儿童中,T细胞亚群没有变化,提示在预防用药时,应该合理、慎重使用免疫调节剂,以免不当治疗和增加患者的经济负担；
②在临床上,对于反复呼吸道感染儿童检测NK细胞是有意义的。
Objective To investigate the impact factors on recurrent upper respiratory tract infections(RRTIs) and change of T lymphocytes、NK cell in children aged 3 to 6 years in Shanxi. For enhancing the quality of children life,avoiding unreasonable therapy in order to explore new method for taking prevention measures.
Methods 230 Children aged 3 to 6 years were collected with strict criterion choice and abandoned. The case group had 118 samples, the control group had 112 samples. case-control study was used. one self-administered questionnaire was used to know children'general information, nutrition, the way parents breed children and family environment. The expression of CD3, CD4, CD8 on T cells; CD16 CD56 on NK cells from peripheral blood was evaluated by a flow cytometry method. SPSS13.0 software were used for data analyses:the equilibrium test compared by t-test andχ2 analysis; the impact factors on RRTIs were analyzed by the Logistic regression. The subset of T lymphocytes compared by Wilcoxon rank sum test of two independent samples, NK cell was compared by t'-test.
Results
1、There were no significant difference in sex(χ2=1.584,P=0.208), age(t=1.650, P=0.100), weight(t=0.341,P=0.733), height(t=0.124,P=0.902) between case group and control group(P>0.05). which indicated that the sample can represent the population.
2、The impact factors on RRTIs:①The risk factors:1 to 3 times intake of vegetables every week (OR=5.195,95%CI(1.193,22.624)), kindergartens (OR=5.642,95%CI (1.149,27.702)),RRTIs disease history (OR=8.129,95%CI (2.725,24.256)), and less than outdoor exercise of 2 hours (OR=5.291,95%CI (1.576,17.763))②The protective factors:the level of father education (OR=0.134,95%CI(0.034,0.527)), taking 4 to 6 times fruits every week (OR=0.231,95%CI(0.069,0.775)), lower 3 frequencies using of antibiotics in one year (OR=0.028,95%CI(0.003,0.303))
3、The subset of T lymphocytes compared by Wilcoxon rank sum test of two independent samples, we concluded that there were no statistically significant difference for all comparisons. CD3+(Z=-1.588, P=0.112), CD4+(Z=-0.541, P=0.588), CD8+(Z=-0.733, P=0.463), CD4+/CD8+(Z=-0.315, P=0.753).
4、There were statistically significant difference in NK cell between two groups. (t'=2.779,P=0.006,95%CI(0.674,4.003))
Conclusions
1、From the conclude of the impact factors:
①Keeping intake of vegetables,fruits, meat.
②Reasonably arrange time of outdoor exercise everyday may decrease the frequencies of
RRTIs.
③It is positive affect for recurrent respiratory tract infections to the higher level of parents'education, especially father.
④Kindergartens should enhance the work of health care. Do examine in morning、noon and evening. Finding the disease'children should be isolation in time. To decrease or avoid the cross-infection.
⑤Respiratory tract infection in children should be therapied in time, and reasonably use the drug, to avoid abusing antibiotic.
2、From the conclude of the lymphocytes:
①For children on RRTIs, T lymphocytes were not change. In prevention, we should reasonable use immunomodulation, to avoid generating a great economic impact.
②In the clinic, flow cytometric analysis of the subset of NK cell is a useful means for RRTIs.
引文
[1]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.反复呼吸道感染的临床概念和处理原则.中华儿科杂志,2008,46(2)：108-109
[2]李廷玉,丁宗一,杨锡强,等.儿童是世界的未来——第24届国际儿科大会简介.中华儿科杂志,2004,42(12)：942-944
[3]陈慧中,胡仪吉.如何认识反复呼吸道感染.中华儿科杂志,2008,46(2)：83-84.
[4]Nencioni E, Chiappini E, Liguori A, et al. Recurrent respiratory infections:why not talking about it any more? Minerva Pediatr,2008,60(6):1411-1416
[5]Panitch Howard B. Evaluation of recurrent pneumonia. Pediatr Infect Dis,2005,24(3):265-266
[6]Malaponte Grazia, Bevelacqua Valentina, Livolti Gilvanni, et al. soluble adhesion molecules and cytokines in children affected by recurrent infections of the upper respiratory tract. International Pediatrics Research Foundation,2004,55(4):666-673
[7]Abdulhamid, Beck F.W.J, Millard S, et al. Effect of zinc supplementation on respiratory tract infections in children with cystic fibrosis. Pediatr Pulmonol,2008,43(3):281-287
[8]Brown KH, Peerson JM, Baker SK,et al. Preventive zinc supplementation among infants, preschoolers, and older prepubertal children. Food Nutr Bull.,2009,30(1):12-40
[9]Savitri Thakur, Neelam Gupta, Poonam Kakkar. Serum copper and zinc concentrations and their relation to superoxide dismutase in severe malnutrition.Eur J Pediatr,2004,163:742-744
[10]Linda A, Lindaya, Jay N, et al. Nutritional supplements as adjunctive therapy for children with chronic/recurrent sinusitis:pilot research. International Journal of Pediatric Otorhinolaryngology,2004,68:785-793
[11]Cameron C, Dallaire F, Vezina C,et al. Neonatal vitamin A deficiency and its impact on acute respiratory infections among preschool Inuit children. Can J Public Health.,2008; 99(2):102-106.
[12]Rahman MA, Mannan MA, Rahman MH,et al. Influence of acute respiratory infection on iron profile in severely malnourished children. Mymensingh Med J.,2008; 17(2):52-58.
[13]Ali NS, Zuberi RW. Association of iron deficiency anaemia in children of 1-2 years of age with low birth weight, recurrent diarrhoea or recurrent respiratory tract infection--a myth or fact? J Pak Med Assoc.,2003,53(4):133-136
[14]Brown N, Roberts C. Vitamin A for acute respiratory infection in developing countries:a meta-analysis. Acta Paediatr.,2004,93(11):1437-1442.
[15]Daniel E Roth, Laura E Caulfield, Majid Ezzati,et al. Acute lower respiratory infections in childhood:opportunities for reducing the global burden through nutritional interventions. Bulletin of the world health organization,2008,86:356-364
[16]Anne B Chang, Paul J Torzillo, Naomi C Boyce,et al. Zinc and vitamin A supplementation in Indigenous Australian children hospitalised with lower respiratory tract infection:a randomised controlled trial. The medical journal of Australia,2006,184(3):107-112
[17]杨清,庞保东,刘革光,等.儿童反复呼吸道感染相关因素的临床研究.中国儿童保健杂志,2008,16(5)：592-593
[18]Jimenez-Gonzalez C, Santini V, Figueroa Cosme WI, et al. Do parents know about the adverse effects of passive smoking and the relationship with respiratory illness on their children? Bol Asoc Med P R.,2008,100(2):39-46.
[19]刘风云,王淑珍,颜世义,等.被动吸烟儿童呼吸健康状况与血清免疫球蛋白含量的相关性. 中国妇幼保健,2008,23(28)：3975-3976
[20]Thomas Kovesi, Nicolas L Gilbert, Corinne Stocco, et al. Indoor air quality and the risk of lower respiratory tractinfections in young Canadian Inuit children. CMAJ,2007,177(2):155-160
[21]胡前胜,余贵英,任铁玲,等. 燃煤对儿童免疫功能的影响研究. 中国公共卫生.,2001,17(10)：875-876
[22]王虹,刘一心,邓文娇,等. 婴儿不同程度锌缺乏症的相关因素分析.中国儿童保健杂志,2007,6(15)：651-652
[23]Christopher C, Winchester DPhil; Tatiana V. Macfarlane et al Antibiotic Prescribing and Outcomes ofLower Respiratory Tract Infection in UK Primary Care. CHEST 2009; 135:1163-1172
[24]查日胜,孙业桓,范亚平,等. 学龄儿童呼吸系统病症影响因素分析. 中国公共卫生,2003,19(12)：1443-1444
[25]Leonelo E.Bautista, Adolfo Correa, Jill Baumgartner, et al. Indoor Charcoal Smoke and Acute Respiratory Infections in Young Children in the Dominican Republic. American Journal of Epidemiology,2009,169:572-580
[26]曾秋霞. 社区散居儿童反复呼吸道感染现状及易感因素分析. 中国初级卫生保健,2007,21(7)：59-60
[27]易著文.疑难儿科学.武汉：湖北科学技术出版社,2002：162
[28]周小燕,余华,邓朝霓. 反复呼吸道感染儿童外周血T淋巴细胞亚群检测的临床意义.中国医药导报,2008,5(28)：105
[29]韩瑞珠,郝艳艳,侯安存. 反复呼吸道感染儿童细胞免疫与体液免疫状况. 实用儿科临床杂志,2007,22(10)：736-737
[30]Bajoriuniene IUrbonieneD, SimonieneG SakalauskasR, Sitkauskiene B. Lymphocyte subsets in patients with recurrent upper airway infections. Kaunas University of Medicine,2005, 5(8):512-520
[31]Wasik M, Kaczorowska M, Demkow U. Altered expression of immune surface markers in children with recurrent infections of respiratory tract. Journal of physiology and pharmacology, 2005,56:237-243
[32]Litzman, J.Lokaj, M.Krejci. Isoprinosine does not protect against frequent respiratory tract infections in childhood. European Journal of Pediatrics,1999,158(1):32-37
[33]JawaharJ S, Moody C, Chan M, et al. Natural killer (NK) cell deficiency associated with an epitope-deficient Fc receptor type ⅢA (CD16-Ⅱ). Clin Exp Immunol,1996,103(3): 408-413.
[34]Bitar M, Khalaf R, Shamseddeen W, et al. Killer cell immunoglobulin-like receptor(KIR)genotypes in patients with recurrent tonsillitis. Genet Test,2008,12(4):517-521
[35]朱秋皎,刘继贤.呼吸道感染患儿检测淋巴细胞亚群的意义.中国血液流变学杂志,2007,17(2)：274-276
[36]杨锡强,易著文,等.儿科学. 北京：人民卫生出版社,2004：304-316
[37]刘宏杰.Logistic回归模型使用注意事项和结果表达.中国公共卫生,2001,5(17)：466-467
[38]联合国儿童基金会.世界儿童状况—儿童生存美国：Hatteras出版公司,2008：113
[39]Maroeska M Rovers, Walter A Balemans, Elisabeth A Sanders, et al. Persistence of upper respiratory tract infections in a cohort followed from childhood to adulthood. Family Practice, 2006,23(3):286-290.
[40]范广勤,冯昶,邹时朴.儿童反复呼吸道感染影响因素的多因素分析. 现代预防医学,2007,34(11)：2058-2062
[41周锦云.反复呼吸道感染患儿微量血锌铁的变化和临床意义.临床和实验医学杂志,2007,6(3)：75
[42]王晓玲.铁缺乏与儿童反复呼吸道感染关系探讨.临床合理用药,2009,2(9)：18-19
[43]G. Kourlaba, K. Kondaki, E. Grammatikaki, et al. Diet quality of preschool children and maternal perceptions/misperceptions The GENESIS study. Public Health,2009,123:738-742
[44]康旭丽. 儿童反复上呼吸道感染危险因素分析. 首都医学,2009,16：36-37
[45]李绍英,沈叙庄,王艳,等.5岁以下儿童门诊呼吸道感染常见病原携带及抗生素耐药的流行病学特征调查.中国实用儿科杂志,2004,4(19)：212-216
[46]Kari J Kv(?)rner, Per Nafstad, Jouni J K Jaakkola. Upper Respiratory Morbidity in Preschool Children A Cross-sectional Study, Arch Otolaryngol Head Neck Surg,2000,126:1201-1206.
[47]马渝燕,刘玺诚,江沁波,等. 反复呼吸道感染儿童支气管粘膜纤毛结构研究. 临床儿科杂志.2003,9(21)：535-538
[48]Yaron Razonl, Shai Ashkenazil, Avner Cohen, et al. Effect of educational intervention on antibiotic prescription practices for upper respiratory infections in children:a multicentre study. Journal of Antimicrobial Chemotherapy,2005,56:937-940.
[49]Chkhaidze I, Manjavidze N, Nemsadze K. Serodiagnosis of acute respiratory infections in children in Georgia. Indian J Pediatr,2006,73:569-572
[50]王丽燕.太原市幼托儿童反复呼吸道感染影响因素的流行病学研究：[硕士学位论文]. 山西：山西医科大学,2005
[51]David C.Nieman, Dru A. Henson, Sarah J. Gross, et al. Quercetin reduces illness but not immune perturbations after intensive exercise. Medicine & Science in Sports & Exercise,2007, 39:1561-1569
[52]张辉明. 运动对免疫功能的影响及其在健身中的应用. 广西工学院学报,2005,4(16)：100-102
[53]邓淑君,廖艳萍,伍鸿鹰. 不同运动强度对免疫机能的影响研究. 湘南学院学报,2008,2(29)：101-104
[54]朱克毅. 反复呼吸道感染患儿缓解期外周血NK细胞的变化. 浙江医学,2000,22(8)：491-492
[1]李廷玉,丁宗一,杨锡强,等.儿童是世界的未来——第24届国际儿科大会简介.中华儿科杂志,2004,42(12)：942-944
[2]陈慧中,胡仪吉. 如何认识反复呼吸道感染. 中华儿科杂志,2008,46(2)：83-84
[3]Nencioni E, Chiappini E, Liguori A, et al. Recurrent respiratory infections:why not talking about it any more? Minerva Pediatr,2008,60(6):1411-1416
[4]Panitch Howard B. Evaluation of recurrent pneumonia. Pediatr Infect Dis,2005, 24(3):265-266
[5]Maroeska M Roversa, Walter A F Balemansd, Elisabeth A M Sandersb,et al. Persistence of upper respiratory tract infections in acohort followed from childhood to adulthood. Family Practice,2006,23:286-290
[6]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. 反复呼吸道感染的临床概念和处理原则. 中华儿科杂志,2008,46(2)：108-109
[7]Abdulhamid, Beck F.W.J, Millard S, et al. Effect of zinc supplementation on respiratory tract infections in children with cystic fibrosis. Pediatr Pulmonol,2008,43(3):281-287
[8]Brown KH, Peerson JM, Baker SK,et al. Preventive zinc supplementation among infants, preschoolers, and older prepubertal children. Food Nutr Bull,2009,30(1):12-40
[9]Savitri Thakur, Neelam Gupta, Poonam Kakkar. Serum copper and zinc concentrations and their relation to superoxide dismutase in severe malnutrition. Eur J Pediatr,2004,163:742-744
[10]Linda A, Lindaya, Jay N, et al. Nutritional supplements as adjunctive therapy for children with chronic/recurrent sinusitis:pilot research. International Journal of Pediatric Otorhinolaryngology,2004,68,785-793
[11]Rahman MA, Mannan MA, Rahman MH, et al. Influence of acute respiratory infection on iron profile in severely malnourished children. Mymensingh Med J.,2008; 17(2):52-58
[12]Ali NS, Zuberi RW. Association of iron deficiency anaemia in children of 1-2 years of age with low birth weight, recurrent diarrhoea or recurrent respiratory tract infection--a myth or fact? J Pak Med Assoc.,2003,53(4):133-136
[13]Cameron C, Dallaire F, Vezina C,et al. Neonatal vitamin A deficiency and its impact on acute respiratory infections among preschool Inuit children. Can J Public Health.,2008, 99(2):102-106.
[14]Brown N, Roberts C. Vitamin A for acute respiratory infection in developing countries:a meta-analysis. Acta Paediatr,2004,93(11):1437-1442
[15]Daniel E Roth, Laura E Caulfield, Majid Ezzati,et al. Acute lower respiratory infections in childhood:opportunities for reducing the global burden through nutritional interventions. Bulletin of the world health organization,2008,86:356-364
[16]Anne B Chang, Paul J Torzillo, Naomi C Boyce, et al. Zinc and vitamin A supplementation in Indigenous Australian children hospitalised with lower respiratory tract infection:a randomised controlled trial. The medical journal of Australia,2006,184(3):107-112
[17]范广勤,冯昶,邹时朴. 儿童反复呼吸道感染影响因素的多因素分析. 现代预防医学,2007,(34)11：2058-2062
[18]周锦云. 反复呼吸道感染患儿微量血锌铁的变化和临床意义.临床和实验医学杂志,2007,6(3)：75
[19]王晓玲.铁缺乏与儿童反复呼吸道感染关系探讨.临床合理用药,2009,2(9)：18-19
[20]作田学. 被动吸烟的诊断标准. 中国医疗前沿,2008,3(4)：114-115
[21]WHO. International consultation on environmental tobacco smoke(ETS)and child health. Consultation report. Genava, Switzer-land:WHO,1999:5
[22]A joint publication by the World Resources Institute, the United Nations Environment Programme, the United Nations Development Programme, the World Bank. World Resoures, 1998-1999:a guide tothe global envir-onment-environmental change and human health. New York, NY:Oxford University Press,1998:37-73
[23]梅翠竹,江蔚,李筱薇.被动吸烟对儿童的健康影响.实用全科医学,2007,5(2)：158-160
[24]Athanassios Chatzimicael, Aggelos Tsalkidis, Dimitrios Cassimos, et al. Effect of passive smoking on lung function and respiratory infection. Indian Journal of Pediatrics,2008, 75:335-340
[25]Leonelo E.Bautista, Adolfo Correa, Jill Baumgartner, et al. Indoor Charcoal Smoke and Acute Respiratory Infections in Young Children in the Dominican Republic.American Journal of Epidemiology,2009,169:572-580.
[26]焦富勇,高德义,刘春风. 被动吸烟与某些小儿疾病的关系研究. 中华儿科杂志,1998,36(9)：572-573.
[27]董淑华,綦宣畅,郭美红,等. 被动吸烟与儿童呼吸道感染的关系及其对鼻纤毛功能的影响.山东医药,2004,44(12)：4-5
[28]杨清,庞保东,刘革光,等. 儿童反复呼吸道感染相关因素的临床研究. 中国儿童保健杂志,2008,16(5)：592-593
[29]刘风云,王淑珍,颜世义,等. 被动吸烟儿童呼吸健康状况与血清免疫球蛋白含量的相关性. 中国妇幼保健,2008,23(28)：3975-3976
[30]牛静萍,丁国武,李嵘. 被动吸烟对儿童免疫功能及生长发育的影晌. 中国公共卫生,2003,19(7)：854-855
[31]刘汝青,宋宏,吴辉,等.被动吸烟对儿童免疫功能的影响.环境与健康杂志,2006,23(2)：146-147
[32]Anders K, Kare M, Preben H, et al. Risk factors acute respiratory tract In young Greenlandic chikdren. American Journal of Epidemiology,2003,158(4):374-384
[33]Kari J Kv(?)rner, Per Nafstad, Jouni J. K. Jaakkola. Upper Respiratory Morbidity in Preschool Children A Cross-sectional Study, Arch Otolaryngol Head Neck Surg,2000, 126:1201-1206
[34]王丽燕.太原市幼托儿童反复呼吸道感染影响因素的流行病学研究：[硕士学位论文]山西：山西医科大学,2005
[35]李绍英,沈叙庄,王艳,等.5岁以下儿童门诊呼吸道感染常见病原携带及抗生素耐药的流行病学特征调查. 中国实用儿科杂志,2004,4(19)：212-216
[36]杨锡强,易著文,主编.儿科学.北京：人民卫生出版社,2004：304-306.
[37]Yaron Razonl, Shai Ashkenazil, Avner Cohen, et al. Effect of educational intervention on antibiotic prescription practices for upper respiratory infections in children:a multicentre study. Journal of Antimicrobial Chemotherapy,2005,56:937-940.
[38]Chkhaidze I, Manjavidze N, Nemsadze K. Serodiagnosis of acute respiratory infections in children in Georgia. Indian J Pediatr,2006,73:569-572.
[39]Christopher C Winchester, Tatiana V. Macfarlane, Mike Thomas, et al. Antibiotic Prescribing and Outcomes of Lower Respiratory Tract Infection in UK Primary Care. Chest, 2009,135:1163-1172.
[40]Thomas Kovesi, Nicolas L. Gilbert, Corinne Stocco,et al. Indoor air quality and the risk of lower respiratory tractinfections in young Canadian Inuit children.CMAJ,2007,177(2):155-160
[41]Kari J Kvaerner, Per Nafstad, Jouni J K Jaakkola. Upper Respiratory Morbidity in Preschool Children A Cross-sectional Study. Arch Otolaryngol Head Neck Surg,2000,126:1201-1206.
[42]Jimenez-Gonzalez C, Santini V, Figueroa Cosme WI, et al. Do parents know about the adverse effects of passive smoking and the relationship with respiratory illness on their children? Bol Asoc Med P R.,2008,100(2):39-46
[43]查日胜,孙业桓,范亚平,等. 学龄儿童呼吸系统病症影响因素分析. 中国公共卫生,2003,19(12)：1443-1444
[44]胡前胜,余贵英,任铁玲,等. 燃煤对儿童免疫功能的影响研究. 中国公共卫生,2001,17(10)：875-876
[45]曾秋霞. 社区散居儿童反复呼吸道感染现状及易感因素分析. 中国初级卫生保健,2007,21(7)：59-60
[46]Beata Zielnik-Jurkiewicz, Dariusz Jurkiewicz. Implication of immunological abnormalities after adenotonsillotomy International. Journal of Pediatric Otorhinolaryngology,2002, 64(2):127-132
[47]马爱义,艾欣.反复呼吸道感染患儿细胞免疫状态的研究.中国免疫学杂志,2003,19：798
[48]Bajoriuniene IUrbonieneD, SimonieneG SakalauskasR, Sitkauskiene B. Lymphocyte subsets in patients with recurrent upper airway infections. Kaunas University of Medicine,2005, 5(8):512-520
[49]Wasik M, Kaczorowska M, Demkow U. Altered expression of immune surface markers in children with recurrent infections of respiratory tract. Journal of physiology and pharmacology, 2005,56:237-243
[50]Malaponte Grazia, Bevelacqua Valentian, Li Volti Glovannt et al. Soluble Adhesion Molecules and Cytokines in Children Affected by Recurrent Infections of the Upper Respiratory Tract. International Pediatrics Research Foundation,2004,55(4):666-673
[51]Li Volti G, Malaponte G, Bevelacqua V, et al. Persistent high plasma levels of interleukins 18 and 4 in children with recurrent infections of the upper respiratory tract. Transplant Proc, 2003,35(8):2911-2915
[52]虞坚尔,霍莉莉,蒋黎敏. 反复呼吸道感染患儿T细胞功能性极化状态. 临床儿科杂志,2007,25(8)：664-667
[53]朱秋皎,刘继贤. 呼吸道感染患儿检测淋巴细胞亚群的意义. 中国血液流变学杂志,2007,17(2)：274-276
[54]朱克毅. 反复呼吸道感染患儿缓解期外周血NK细胞的变化. 浙江医学,2000,22(8)：491-492
[55]JawaharJ S, Moody C, Chan M, et al. Natural killer (NK) cell deficiency associated with an epitope-deficient Fc receptor type ⅢA (CD16-Ⅱ), Clin Exp Immunol,1996,103(3): 408-413.
[56]Bitar M, Khalaf R, Shamseddeen W, et al. Killer cell immunoglobulin-like receptor(KIR)genotypes in patients with recurrent tonsillitis. Genet Test,2008,12(4):517-521
[2]李廷玉,丁宗一,杨锡强,等.儿童是世界的未来——第24届国际儿科大会简介.中华儿科杂志,2004,42(12)：942-944
[3]陈慧中,胡仪吉.如何认识反复呼吸道感染.中华儿科杂志,2008,46(2)：83-84.
[4]Nencioni E, Chiappini E, Liguori A, et al. Recurrent respiratory infections:why not talking about it any more? Minerva Pediatr,2008,60(6):1411-1416
[5]Panitch Howard B. Evaluation of recurrent pneumonia. Pediatr Infect Dis,2005,24(3):265-266
[6]Malaponte Grazia, Bevelacqua Valentina, Livolti Gilvanni, et al. soluble adhesion molecules and cytokines in children affected by recurrent infections of the upper respiratory tract. International Pediatrics Research Foundation,2004,55(4):666-673
[7]Abdulhamid, Beck F.W.J, Millard S, et al. Effect of zinc supplementation on respiratory tract infections in children with cystic fibrosis. Pediatr Pulmonol,2008,43(3):281-287
[8]Brown KH, Peerson JM, Baker SK,et al. Preventive zinc supplementation among infants, preschoolers, and older prepubertal children. Food Nutr Bull.,2009,30(1):12-40
[9]Savitri Thakur, Neelam Gupta, Poonam Kakkar. Serum copper and zinc concentrations and their relation to superoxide dismutase in severe malnutrition.Eur J Pediatr,2004,163:742-744
[10]Linda A, Lindaya, Jay N, et al. Nutritional supplements as adjunctive therapy for children with chronic/recurrent sinusitis:pilot research. International Journal of Pediatric Otorhinolaryngology,2004,68:785-793
[11]Cameron C, Dallaire F, Vezina C,et al. Neonatal vitamin A deficiency and its impact on acute respiratory infections among preschool Inuit children. Can J Public Health.,2008; 99(2):102-106.
[12]Rahman MA, Mannan MA, Rahman MH,et al. Influence of acute respiratory infection on iron profile in severely malnourished children. Mymensingh Med J.,2008; 17(2):52-58.
[13]Ali NS, Zuberi RW. Association of iron deficiency anaemia in children of 1-2 years of age with low birth weight, recurrent diarrhoea or recurrent respiratory tract infection--a myth or fact? J Pak Med Assoc.,2003,53(4):133-136
[14]Brown N, Roberts C. Vitamin A for acute respiratory infection in developing countries:a meta-analysis. Acta Paediatr.,2004,93(11):1437-1442.
[15]Daniel E Roth, Laura E Caulfield, Majid Ezzati,et al. Acute lower respiratory infections in childhood:opportunities for reducing the global burden through nutritional interventions. Bulletin of the world health organization,2008,86:356-364
[16]Anne B Chang, Paul J Torzillo, Naomi C Boyce,et al. Zinc and vitamin A supplementation in Indigenous Australian children hospitalised with lower respiratory tract infection:a randomised controlled trial. The medical journal of Australia,2006,184(3):107-112
[17]杨清,庞保东,刘革光,等.儿童反复呼吸道感染相关因素的临床研究.中国儿童保健杂志,2008,16(5)：592-593
[18]Jimenez-Gonzalez C, Santini V, Figueroa Cosme WI, et al. Do parents know about the adverse effects of passive smoking and the relationship with respiratory illness on their children? Bol Asoc Med P R.,2008,100(2):39-46.
[19]刘风云,王淑珍,颜世义,等.被动吸烟儿童呼吸健康状况与血清免疫球蛋白含量的相关性. 中国妇幼保健,2008,23(28)：3975-3976
[20]Thomas Kovesi, Nicolas L Gilbert, Corinne Stocco, et al. Indoor air quality and the risk of lower respiratory tractinfections in young Canadian Inuit children. CMAJ,2007,177(2):155-160
[21]胡前胜,余贵英,任铁玲,等. 燃煤对儿童免疫功能的影响研究. 中国公共卫生.,2001,17(10)：875-876
[22]王虹,刘一心,邓文娇,等. 婴儿不同程度锌缺乏症的相关因素分析.中国儿童保健杂志,2007,6(15)：651-652
[23]Christopher C, Winchester DPhil; Tatiana V. Macfarlane et al Antibiotic Prescribing and Outcomes ofLower Respiratory Tract Infection in UK Primary Care. CHEST 2009; 135:1163-1172
[24]查日胜,孙业桓,范亚平,等. 学龄儿童呼吸系统病症影响因素分析. 中国公共卫生,2003,19(12)：1443-1444
[25]Leonelo E.Bautista, Adolfo Correa, Jill Baumgartner, et al. Indoor Charcoal Smoke and Acute Respiratory Infections in Young Children in the Dominican Republic. American Journal of Epidemiology,2009,169:572-580
[26]曾秋霞. 社区散居儿童反复呼吸道感染现状及易感因素分析. 中国初级卫生保健,2007,21(7)：59-60
[27]易著文.疑难儿科学.武汉：湖北科学技术出版社,2002：162
[28]周小燕,余华,邓朝霓. 反复呼吸道感染儿童外周血T淋巴细胞亚群检测的临床意义.中国医药导报,2008,5(28)：105
[29]韩瑞珠,郝艳艳,侯安存. 反复呼吸道感染儿童细胞免疫与体液免疫状况. 实用儿科临床杂志,2007,22(10)：736-737
[30]Bajoriuniene IUrbonieneD, SimonieneG SakalauskasR, Sitkauskiene B. Lymphocyte subsets in patients with recurrent upper airway infections. Kaunas University of Medicine,2005, 5(8):512-520
[31]Wasik M, Kaczorowska M, Demkow U. Altered expression of immune surface markers in children with recurrent infections of respiratory tract. Journal of physiology and pharmacology, 2005,56:237-243
[32]Litzman, J.Lokaj, M.Krejci. Isoprinosine does not protect against frequent respiratory tract infections in childhood. European Journal of Pediatrics,1999,158(1):32-37
[33]JawaharJ S, Moody C, Chan M, et al. Natural killer (NK) cell deficiency associated with an epitope-deficient Fc receptor type ⅢA (CD16-Ⅱ). Clin Exp Immunol,1996,103(3): 408-413.
[34]Bitar M, Khalaf R, Shamseddeen W, et al. Killer cell immunoglobulin-like receptor(KIR)genotypes in patients with recurrent tonsillitis. Genet Test,2008,12(4):517-521
[35]朱秋皎,刘继贤.呼吸道感染患儿检测淋巴细胞亚群的意义.中国血液流变学杂志,2007,17(2)：274-276
[36]杨锡强,易著文,等.儿科学. 北京：人民卫生出版社,2004：304-316
[37]刘宏杰.Logistic回归模型使用注意事项和结果表达.中国公共卫生,2001,5(17)：466-467
[38]联合国儿童基金会.世界儿童状况—儿童生存美国：Hatteras出版公司,2008：113
[39]Maroeska M Rovers, Walter A Balemans, Elisabeth A Sanders, et al. Persistence of upper respiratory tract infections in a cohort followed from childhood to adulthood. Family Practice, 2006,23(3):286-290.
[40]范广勤,冯昶,邹时朴.儿童反复呼吸道感染影响因素的多因素分析. 现代预防医学,2007,34(11)：2058-2062
[41周锦云.反复呼吸道感染患儿微量血锌铁的变化和临床意义.临床和实验医学杂志,2007,6(3)：75
[42]王晓玲.铁缺乏与儿童反复呼吸道感染关系探讨.临床合理用药,2009,2(9)：18-19
[43]G. Kourlaba, K. Kondaki, E. Grammatikaki, et al. Diet quality of preschool children and maternal perceptions/misperceptions The GENESIS study. Public Health,2009,123:738-742
[44]康旭丽. 儿童反复上呼吸道感染危险因素分析. 首都医学,2009,16：36-37
[45]李绍英,沈叙庄,王艳,等.5岁以下儿童门诊呼吸道感染常见病原携带及抗生素耐药的流行病学特征调查.中国实用儿科杂志,2004,4(19)：212-216
[46]Kari J Kv(?)rner, Per Nafstad, Jouni J K Jaakkola. Upper Respiratory Morbidity in Preschool Children A Cross-sectional Study, Arch Otolaryngol Head Neck Surg,2000,126:1201-1206.
[47]马渝燕,刘玺诚,江沁波,等. 反复呼吸道感染儿童支气管粘膜纤毛结构研究. 临床儿科杂志.2003,9(21)：535-538
[48]Yaron Razonl, Shai Ashkenazil, Avner Cohen, et al. Effect of educational intervention on antibiotic prescription practices for upper respiratory infections in children:a multicentre study. Journal of Antimicrobial Chemotherapy,2005,56:937-940.
[49]Chkhaidze I, Manjavidze N, Nemsadze K. Serodiagnosis of acute respiratory infections in children in Georgia. Indian J Pediatr,2006,73:569-572
[50]王丽燕.太原市幼托儿童反复呼吸道感染影响因素的流行病学研究：[硕士学位论文]. 山西：山西医科大学,2005
[51]David C.Nieman, Dru A. Henson, Sarah J. Gross, et al. Quercetin reduces illness but not immune perturbations after intensive exercise. Medicine & Science in Sports & Exercise,2007, 39:1561-1569
[52]张辉明. 运动对免疫功能的影响及其在健身中的应用. 广西工学院学报,2005,4(16)：100-102
[53]邓淑君,廖艳萍,伍鸿鹰. 不同运动强度对免疫机能的影响研究. 湘南学院学报,2008,2(29)：101-104
[54]朱克毅. 反复呼吸道感染患儿缓解期外周血NK细胞的变化. 浙江医学,2000,22(8)：491-492
[1]李廷玉,丁宗一,杨锡强,等.儿童是世界的未来——第24届国际儿科大会简介.中华儿科杂志,2004,42(12)：942-944
[2]陈慧中,胡仪吉. 如何认识反复呼吸道感染. 中华儿科杂志,2008,46(2)：83-84
[3]Nencioni E, Chiappini E, Liguori A, et al. Recurrent respiratory infections:why not talking about it any more? Minerva Pediatr,2008,60(6):1411-1416
[4]Panitch Howard B. Evaluation of recurrent pneumonia. Pediatr Infect Dis,2005, 24(3):265-266
[5]Maroeska M Roversa, Walter A F Balemansd, Elisabeth A M Sandersb,et al. Persistence of upper respiratory tract infections in acohort followed from childhood to adulthood. Family Practice,2006,23:286-290
[6]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. 反复呼吸道感染的临床概念和处理原则. 中华儿科杂志,2008,46(2)：108-109
[7]Abdulhamid, Beck F.W.J, Millard S, et al. Effect of zinc supplementation on respiratory tract infections in children with cystic fibrosis. Pediatr Pulmonol,2008,43(3):281-287
[8]Brown KH, Peerson JM, Baker SK,et al. Preventive zinc supplementation among infants, preschoolers, and older prepubertal children. Food Nutr Bull,2009,30(1):12-40
[9]Savitri Thakur, Neelam Gupta, Poonam Kakkar. Serum copper and zinc concentrations and their relation to superoxide dismutase in severe malnutrition. Eur J Pediatr,2004,163:742-744
[10]Linda A, Lindaya, Jay N, et al. Nutritional supplements as adjunctive therapy for children with chronic/recurrent sinusitis:pilot research. International Journal of Pediatric Otorhinolaryngology,2004,68,785-793
[11]Rahman MA, Mannan MA, Rahman MH, et al. Influence of acute respiratory infection on iron profile in severely malnourished children. Mymensingh Med J.,2008; 17(2):52-58
[12]Ali NS, Zuberi RW. Association of iron deficiency anaemia in children of 1-2 years of age with low birth weight, recurrent diarrhoea or recurrent respiratory tract infection--a myth or fact? J Pak Med Assoc.,2003,53(4):133-136
[13]Cameron C, Dallaire F, Vezina C,et al. Neonatal vitamin A deficiency and its impact on acute respiratory infections among preschool Inuit children. Can J Public Health.,2008, 99(2):102-106.
[14]Brown N, Roberts C. Vitamin A for acute respiratory infection in developing countries:a meta-analysis. Acta Paediatr,2004,93(11):1437-1442
[15]Daniel E Roth, Laura E Caulfield, Majid Ezzati,et al. Acute lower respiratory infections in childhood:opportunities for reducing the global burden through nutritional interventions. Bulletin of the world health organization,2008,86:356-364
[16]Anne B Chang, Paul J Torzillo, Naomi C Boyce, et al. Zinc and vitamin A supplementation in Indigenous Australian children hospitalised with lower respiratory tract infection:a randomised controlled trial. The medical journal of Australia,2006,184(3):107-112
[17]范广勤,冯昶,邹时朴. 儿童反复呼吸道感染影响因素的多因素分析. 现代预防医学,2007,(34)11：2058-2062
[18]周锦云. 反复呼吸道感染患儿微量血锌铁的变化和临床意义.临床和实验医学杂志,2007,6(3)：75
[19]王晓玲.铁缺乏与儿童反复呼吸道感染关系探讨.临床合理用药,2009,2(9)：18-19
[20]作田学. 被动吸烟的诊断标准. 中国医疗前沿,2008,3(4)：114-115
[21]WHO. International consultation on environmental tobacco smoke(ETS)and child health. Consultation report. Genava, Switzer-land:WHO,1999:5
[22]A joint publication by the World Resources Institute, the United Nations Environment Programme, the United Nations Development Programme, the World Bank. World Resoures, 1998-1999:a guide tothe global envir-onment-environmental change and human health. New York, NY:Oxford University Press,1998:37-73
[23]梅翠竹,江蔚,李筱薇.被动吸烟对儿童的健康影响.实用全科医学,2007,5(2)：158-160
[24]Athanassios Chatzimicael, Aggelos Tsalkidis, Dimitrios Cassimos, et al. Effect of passive smoking on lung function and respiratory infection. Indian Journal of Pediatrics,2008, 75:335-340
[25]Leonelo E.Bautista, Adolfo Correa, Jill Baumgartner, et al. Indoor Charcoal Smoke and Acute Respiratory Infections in Young Children in the Dominican Republic.American Journal of Epidemiology,2009,169:572-580.
[26]焦富勇,高德义,刘春风. 被动吸烟与某些小儿疾病的关系研究. 中华儿科杂志,1998,36(9)：572-573.
[27]董淑华,綦宣畅,郭美红,等. 被动吸烟与儿童呼吸道感染的关系及其对鼻纤毛功能的影响.山东医药,2004,44(12)：4-5
[28]杨清,庞保东,刘革光,等. 儿童反复呼吸道感染相关因素的临床研究. 中国儿童保健杂志,2008,16(5)：592-593
[29]刘风云,王淑珍,颜世义,等. 被动吸烟儿童呼吸健康状况与血清免疫球蛋白含量的相关性. 中国妇幼保健,2008,23(28)：3975-3976
[30]牛静萍,丁国武,李嵘. 被动吸烟对儿童免疫功能及生长发育的影晌. 中国公共卫生,2003,19(7)：854-855
[31]刘汝青,宋宏,吴辉,等.被动吸烟对儿童免疫功能的影响.环境与健康杂志,2006,23(2)：146-147
[32]Anders K, Kare M, Preben H, et al. Risk factors acute respiratory tract In young Greenlandic chikdren. American Journal of Epidemiology,2003,158(4):374-384
[33]Kari J Kv(?)rner, Per Nafstad, Jouni J. K. Jaakkola. Upper Respiratory Morbidity in Preschool Children A Cross-sectional Study, Arch Otolaryngol Head Neck Surg,2000, 126:1201-1206
[34]王丽燕.太原市幼托儿童反复呼吸道感染影响因素的流行病学研究：[硕士学位论文]山西：山西医科大学,2005
[35]李绍英,沈叙庄,王艳,等.5岁以下儿童门诊呼吸道感染常见病原携带及抗生素耐药的流行病学特征调查. 中国实用儿科杂志,2004,4(19)：212-216
[36]杨锡强,易著文,主编.儿科学.北京：人民卫生出版社,2004：304-306.
[37]Yaron Razonl, Shai Ashkenazil, Avner Cohen, et al. Effect of educational intervention on antibiotic prescription practices for upper respiratory infections in children:a multicentre study. Journal of Antimicrobial Chemotherapy,2005,56:937-940.
[38]Chkhaidze I, Manjavidze N, Nemsadze K. Serodiagnosis of acute respiratory infections in children in Georgia. Indian J Pediatr,2006,73:569-572.
[39]Christopher C Winchester, Tatiana V. Macfarlane, Mike Thomas, et al. Antibiotic Prescribing and Outcomes of Lower Respiratory Tract Infection in UK Primary Care. Chest, 2009,135:1163-1172.
[40]Thomas Kovesi, Nicolas L. Gilbert, Corinne Stocco,et al. Indoor air quality and the risk of lower respiratory tractinfections in young Canadian Inuit children.CMAJ,2007,177(2):155-160
[41]Kari J Kvaerner, Per Nafstad, Jouni J K Jaakkola. Upper Respiratory Morbidity in Preschool Children A Cross-sectional Study. Arch Otolaryngol Head Neck Surg,2000,126:1201-1206.
[42]Jimenez-Gonzalez C, Santini V, Figueroa Cosme WI, et al. Do parents know about the adverse effects of passive smoking and the relationship with respiratory illness on their children? Bol Asoc Med P R.,2008,100(2):39-46
[43]查日胜,孙业桓,范亚平,等. 学龄儿童呼吸系统病症影响因素分析. 中国公共卫生,2003,19(12)：1443-1444
[44]胡前胜,余贵英,任铁玲,等. 燃煤对儿童免疫功能的影响研究. 中国公共卫生,2001,17(10)：875-876
[45]曾秋霞. 社区散居儿童反复呼吸道感染现状及易感因素分析. 中国初级卫生保健,2007,21(7)：59-60
[46]Beata Zielnik-Jurkiewicz, Dariusz Jurkiewicz. Implication of immunological abnormalities after adenotonsillotomy International. Journal of Pediatric Otorhinolaryngology,2002, 64(2):127-132
[47]马爱义,艾欣.反复呼吸道感染患儿细胞免疫状态的研究.中国免疫学杂志,2003,19：798
[48]Bajoriuniene IUrbonieneD, SimonieneG SakalauskasR, Sitkauskiene B. Lymphocyte subsets in patients with recurrent upper airway infections. Kaunas University of Medicine,2005, 5(8):512-520
[49]Wasik M, Kaczorowska M, Demkow U. Altered expression of immune surface markers in children with recurrent infections of respiratory tract. Journal of physiology and pharmacology, 2005,56:237-243
[50]Malaponte Grazia, Bevelacqua Valentian, Li Volti Glovannt et al. Soluble Adhesion Molecules and Cytokines in Children Affected by Recurrent Infections of the Upper Respiratory Tract. International Pediatrics Research Foundation,2004,55(4):666-673
[51]Li Volti G, Malaponte G, Bevelacqua V, et al. Persistent high plasma levels of interleukins 18 and 4 in children with recurrent infections of the upper respiratory tract. Transplant Proc, 2003,35(8):2911-2915
[52]虞坚尔,霍莉莉,蒋黎敏. 反复呼吸道感染患儿T细胞功能性极化状态. 临床儿科杂志,2007,25(8)：664-667
[53]朱秋皎,刘继贤. 呼吸道感染患儿检测淋巴细胞亚群的意义. 中国血液流变学杂志,2007,17(2)：274-276
[54]朱克毅. 反复呼吸道感染患儿缓解期外周血NK细胞的变化. 浙江医学,2000,22(8)：491-492
[55]JawaharJ S, Moody C, Chan M, et al. Natural killer (NK) cell deficiency associated with an epitope-deficient Fc receptor type ⅢA (CD16-Ⅱ), Clin Exp Immunol,1996,103(3): 408-413.
[56]Bitar M, Khalaf R, Shamseddeen W, et al. Killer cell immunoglobulin-like receptor(KIR)genotypes in patients with recurrent tonsillitis. Genet Test,2008,12(4):517-521