Rivera Claros R, Marín V, Castillo-Durán C, Jara L, Guardia S, Díaz N
INTA-Universidad de Chile, Servicio de Pediatría, Hospital San Juan de Dios.
Arch Latinoam Nutr. 1999 Dec;49(4):326-32.
Respiratory syncycial virus (RSV) is the first cause of acute lower respiratory tract infection in Chilean infants. A significant impact of nutrition on clinical course of these infections has been described. In order to analyze the association between nutritional status (NS) and clinical course of infants hospitalized with acute lower respiratory tract infection due to RSV, 130 infants (mean age 5.8 +/- 4.9 m) without chronic diseases, admitted to hospital with confirmed RSV infection, were studied. Clinical course of disease was assessed (hospitalization days and days with oxygen therapy) according to nutritional status on admission (weight/length (W/L), ratio, arm muscle area, lymphocyte count and albumin), antropometrics changes, and hospital dietary intake. On admission prevalence of malnutrition by W/L (z score) was 1%, 14% overweight and 8% were obese. Median value of hospitalization days was 5 d (2-29 d) and days receiving oxygen was 3 d (0-19 d). Longer admission were observed in fasted patients than in those who were fed everyday (Wilcoxon and Log-rank test, 8 d vs 5 d; P < 0.01). Obese children (Wilcoxon and Log-rank test, 5 d vs. 3d in normal patients; P < 0.05), and patients not fed enterally (Wilcoxon and Log-rank test, 7 d vs. 3 d; P < 0.01) required oxygen for longer time. Fasting and severity of illness (Tal score) were correlated variables (X2 0.001). The multivariate analysis showed an association of Tal score and NS on admission, with days receiving oxygen therapy. We conclude that obesity is a risk factor for worse clinical course of acute lower respiratory tract infection in Chilean infants with RSV infection and without chronic disease.
呼吸道合胞病毒（RSV）是智利婴儿急性下呼吸道感染的首要病因。已有研究表明营养状况对这些感染的临床病程有显著影响。为分析营养状况（NS）与因RSV感染导致急性下呼吸道感染而住院的婴儿临床病程之间的关联，我们对130例无慢性疾病、因确诊RSV感染而入院的婴儿（平均年龄5.8±4.9个月）进行了研究。根据入院时的营养状况（体重/身长（W/L）、比值、上臂肌肉面积、淋巴细胞计数和白蛋白）、人体测量学变化以及医院饮食摄入量，对疾病的临床病程（住院天数和吸氧天数）进行了评估。入院时，根据W/L（z评分）判断的营养不良患病率为1%，超重率为14%，肥胖率为8%。住院天数的中位数为5天（2 - 29天），吸氧天数为3天（0 - 19天）。观察到禁食患者的住院时间比每天进食的患者更长（Wilcoxon和对数秩检验，8天对5天；P < 0.01）。肥胖儿童（Wilcoxon和对数秩检验，正常患者为5天对3天；P < 0.05）以及未接受肠内营养的患者（Wilcoxon和对数秩检验，7天对3天；P < 0.01）需要吸氧的时间更长。禁食与疾病严重程度（Tal评分）是相关变量（X2 0.001）。多变量分析显示，Tal评分与入院时的营养状况与吸氧天数之间存在关联。我们得出结论，肥胖是智利无慢性疾病的RSV感染婴儿急性下呼吸道感染临床病程恶化的一个危险因素。
