Ramakrishnan K, Harish P S
Department of Pediatrics, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India.
Indian J Pediatr. 2006 Oct;73(10):881-3. doi: 10.1007/BF02859279.
This prospective study was conducted to evaluate the role of hemoglobin level, as a risk factor for Lower Respiratory Tract Infections in children (LRTI).
100 children who came to the outpatient department for LRTI were included in the study. Age and sex-matched 100 children, not having any respiratory illness, were taken as control. They were subjected to complete blood count (CBC),C-reactive protein estimation (CRP), Mantoux test and X-ray chest. Peripheral smear, serum ferritin and serum iron binding capacity were done for all anemic children. Results. Radiological evidence of pneumonia was present in 63 children(63%).Hyper inflated lungs were seen in 27 (27%). Mantoux was positive in 22 children (22%) of study group and none among control group. CRP > 6 mg/L was noted in 45 children (45%) of study group and 14 (14%) of control group. Seventy four of study group (74 %) and 33 of control group (33%) had anemia. Of the anemic children, 60 (60%) had iron deficiency,10 (10%) chronic inflammation and 4 (4%) had hemolytic anemia. These values were 30 (30%), 2 (2%) and 1 (1%)respectively for control group. Low hemoglobin level due to whatever etiology, was a risk factor (p=0.000).
Anemic children were 5.75 times more susceptible to LRTI compared to the control group. Prevention of anemia, due to whatever etiology, will reduce the incidence of LRTI.
本前瞻性研究旨在评估血红蛋白水平作为儿童下呼吸道感染(LRTI)危险因素的作用。
100名因下呼吸道感染前来门诊的儿童纳入研究。选取100名年龄和性别匹配、无任何呼吸道疾病的儿童作为对照。对他们进行全血细胞计数(CBC)、C反应蛋白测定(CRP)、结核菌素试验和胸部X线检查。对所有贫血儿童进行外周血涂片、血清铁蛋白和血清铁结合能力检测。结果。63名儿童(63%)有肺炎的影像学证据。27名(27%)可见肺过度充气。研究组22名儿童(22%)结核菌素试验呈阳性,对照组无阳性。研究组45名儿童(45%)CRP>6mg/L,对照组14名(14%)。研究组74名(74%)和对照组33名(33%)有贫血。在贫血儿童中,60名(60%)缺铁,10名(10%)有慢性炎症,4名(4%)有溶血性贫血。对照组这些值分别为30名(30%)、2名(2%)和1名(1%)。无论病因如何,低血红蛋白水平都是一个危险因素(p=0.000)。
与对照组相比,贫血儿童患下呼吸道感染的易感性高5.75倍。无论病因如何,预防贫血将降低下呼吸道感染的发病率。