摘要
目的分析学龄前期儿童急性下呼吸道感染合并呼吸道合胞病毒(RSV)感染的临床特征及其影响因素。方法回顾性分析2020年1月-2021年12月中国医科大学附属盛京医院收治的776例学龄前期急性下呼吸道感染患儿的临床资料,根据患儿是否发生RSV感染将其分为RSV感染组(n=102)、非RSV感染组(n=674)。统计学龄前期急性下呼吸道感染合并RSV感染患儿的临床特征,采用多因素Logistic回归分析学龄前期儿童急性下呼吸道感染合并RSV感染的危险因素,构建预测模型,采用受试者工作特征(ROC)曲线分析预测模型对学龄前期儿童急性下呼吸道感染合并RSV感染的预测价值。结果低出生体质量、发病季节为秋冬、血清免疫球蛋白G(IgG)、IgM、外周血CD_(4)^(+)、CD_(19)^(+)水平较低,血清白细胞介素-6(IL-6)、C-反应蛋白(CRP)、外周血CD_(8)^(+)、中性粒细胞较高均为学龄前期急性下呼吸道感染患儿合并RSV感染的影响因素(P<0.05);根据Logistic回归分析结果构建预测模型:logit(P)=-11.025+低出生体质量×1.241+发病季节为秋冬×1.027+IgG×0.836+IgM×1.293+CD_(4)^(+)×1.056+CD_(19)^(+)×1.172+IL-6×0.996+CRP×0.793+CD_(8)^(+)×1.137+中性粒细胞×1.196;ROC曲线分析结果显示,当logit(P)>12.58时,曲线下面积(AUC)值为0.899,95%CI为0.876~0.919,敏感度为80.39%,特异度为82.05%。结论学龄前期急性下呼吸道感染患儿合并RSV感染的影响因素包括低出生体质量、发病季节为秋冬、血清IgG、IgM、外周血CD_(4)^(+)、CD_(19)^(+),血清IL-6、CRP、外周血CD_(8)^(+)、中性粒细胞水平,据此构建预测模型对学龄前期急性下呼吸道感染患儿合并RSV感染具有较好的预测价值,临床可根据此预测模型对有以上特征的患儿进行针对性干预或治疗,降低患儿RSV感染发生的风险。
OBJECTIVE To analyze the clinical characteristics of acute lower respiratory tract infection complicated with respiratory syncytial virus(RSV)infection in pre-school-age children and influencing factors.METHODS The clinical data of 776 pre-school-age children with acute lower respiratory tract infection admitted to Shengjing Hospital of China Medical University from Jan.2020 to Dec.2021 were retrospectively analyzed,and they were divided into the RSV-infected group(n=102)and the non-RSV-infected group(n=674)according to whether the children had RSV infection.The clinical characteristics of pre-school-age children with acute lower respiratory tract infection complicated with RSV infection were analyzed,multivariate Logistic regression was used to analyze the risk factors for acute lower respiratory tract infection complicated with RSV infection in pre-school-age children,and a predictive model was constructed,and the receiver operating characteristic(ROC)curve was used to analyze the predictive value of the prediction model for acute lower respiratory tract infection complicated with RSV infection in pre-school-age children.RESULTS Multivariate Logistic regression analysis showed that low birth weight,onset season in autumn and winter,low levels of serum immunoglobulin G(IgG),immunoglobulin M(IgM),peripheral blood CD_(4)^(+),and CD_(19)^(+),high levels of serum interleukin-6(IL-6),C-reactive protein(CRP),peripheral blood CD_(8)^(+)and neutrophil were independent risk factors for co-infection of RSV in pre-school-age children with acute lower respiratory tract infection(P<0.05).The prediction model was constructed based on the results of Logistic regression analysis:Logit(P)=-11.025+low birth weight×1.241+autumn and winter×1.027+IgG×0.836+IgM×1.293+CD_(4)^(+)×1.056+CD_(19)^(+)×1.172+IL-6×0.996+CRP×0.793+CD_(8)^(+)×1.137+neutrophil×1.196.ROC curve analysis showed that when logit(P)12.58,an AUC value was 0.899,95%CI was 0.876~0.919,sensitivity was 80.39%,specificity was 82.05%.CONCLUSION The independent ris
作者
刘月娜
贺琳晰
张涛
周明杨
赵璠
LIU Yue-na;HE Lin-xi;ZHANG Tao;ZHOU Ming-yang;ZHAO Fan(Shengjing Hospital of China Medical University,Shenyang,Liaoning 110004,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2023年第11期1731-1735,共5页
Chinese Journal of Nosocomiology
基金
辽宁省科研基金资助项目(2021LJ1021)。
关键词
急性下呼吸道感染
呼吸道合胞病毒感染
学龄前儿童
临床特征
影响因素
预测模型
Acute lower respiratory tract infection
Respiratory syncytial virus infection
Pre-school age children
Clinical features
Factors affecting
Prediction model
