儿童呼吸道感染的临床特征、预后及其影响因素分析

  目的  探讨儿童呼吸道感染的临床特征和主要致病菌，分析患儿预后情况及预后不良的相关因素。  方法  便利抽样法选择2018年1月—2019年12月在浙江省人民医院住院治疗的1 246例呼吸道感染患儿为研究对象，回顾性分析其呼吸道感染致病菌类型，统计儿童呼吸道感染的预后情况，采用多因素logistic回归分析统计儿童呼吸道感染预后不良的相关因素。  结果  1 246例呼吸道感染患儿中有387例呼吸道病毒检出阳性，检出率为31.1%；检出病毒中以呼吸道合胞病毒(RSV)检出阳性例数最多，检出率为62.8%(243/387)，其次为A型流感病毒(Flu A)，检出率为22.5%(87/387)；经治疗后95.2%(1 186/1 246)的患儿好转，4.8%(60/1 246)的患儿预后不良。单因素分析显示:父母有过敏史、吸二手烟、无户外活动、春冬季和年龄在1岁以下的呼吸道感染患儿预后不良(P＜0.001)；多因素logistic分析结果显示:无户外活动、春冬季和年龄在1岁以下是患儿预后不良的危险因素(均P＜0.05)。  结论  儿童呼吸道感染主要致病菌为RSV，预后不良的患儿比例较高，且以冬春季为主，1岁以下患儿为易感人群，应在日常生活中增加户外活动、保障均衡饮食、提高患儿免疫功能。 

Clinical features,prognosis,and influencing factors of respiratory tract infection in children

Objective To explore the clinical characteristics and main pathogenic bacteria of respiratory tract infection in children, to analyse the prognosis and related factors of children with poor prognosis, and to provide clinical basis for good prognosis of children with respiratory tract infection. Methods From January 2018 to December 2019, 1 246 children with respiratory tract infection were selected as the subjects of study. The types of respiratory tract infection pathogens were retrospectively analysed, and the prognosis of children with respiratory tract infection was counted. Multivariate logistic regression analysis was used to determine the prognostic factors of children with respiratory tract infection. Results Amongst the 1 246 children with respiratory infections, 387 were positive for respiratory viruses, the incidence was 31.1%. Respiratory syncytial virus(RSV) was the highest number of positive cases, with a composition ratio of 62.8%(243/387), followed by Influenza A virus(Flu A), with a composition ratio of 22.5%(87/387). After treatment, 95.2%(1 186/1 246) of the children improved, the prognosis of 4.8%(60/1 246) children was poor. Univariate analysis showed statistically significant differences in the prognosis of children with allergic history, second-hand smoke, no outdoor activities, respiratory tract infections in spring, winter, and under one year of age(P<0.001). Multivariate logistic analysis results showed that no outdoor activities, spring, winter, and age under 1 years were risk factors for poor prognosis(all P<0.05). Conclusion RSV is the main pathogen of respiratory tract infection in children, and the proportion of children with poor prognosis is high, and mainly in winter and spring. Children under 1 year old are the susceptible population, and they should increase outdoor activities in daily life, ensure a balanced diet, and improve their immune function.