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儿童呼吸道感染并发低钠血症:3938 例患者队列的横断面分析。

Hyponatremia in children with respiratory infections: a cross-sectional analysis of a cohort of 3938 patients.

机构信息

Department of Pediatrics, Dankook University College of Medicine, Cheil General Hospital & Woman's Health Care Center, Seoul, Korea.

Department of Laboratory Medicine, Dankook University College of Medicine, Cheil General Hospital & Woman's Health Care Center, Seoul, Korea.

出版信息

Sci Rep. 2018 Nov 7;8(1):16494. doi: 10.1038/s41598-018-34703-1.

Abstract

Hyponatremia can be a life-threatening illness among hospitalized children. The aims of this study were to evaluate the incidence and risk factors of hyponatremia in 3938 children who were admitted to the Cheil General Hospital and Women's Health Care Center with respiratory infections. Clinical data were collected, and multiplex RT-PCR analyses were done for various microorganisms. Hyponatremia was observed in 531 (13.5%) patients. The incidence of hyponatremia differed according to the respiratory tract infection (P < 0.0001) and microorganism (P = 0.001). In children with hyponatremia, the age at admission was significantly older (P < 0.0001), male gender was more frequent (P = 0.019), CRP was higher (P < 0.0001), and coinfection with multiple organisms was more common (P = 0.001) than in children without hyponatremia. In multivariate analyses, an older age at admission (P = 0.006), male gender (P = 0.004), and increased CRP (P < 0.0001) were independent risk factors. Sodium levels correlated negatively with WBC (P = 0.037), CRP (P < 0.0001), and number of hospital days (P = 0.020). The AUC values of age (0.586, P < 0.0001), CRP (0.599, P < 0.0001), and blood urea nitrogen (0.559, P < 0.0001) were all significant predictors of hyponatremia. This study is the first to show that the incidence of hyponatremia differs according to infecting microorganism and radiological findings.

摘要

低钠血症可危及住院患儿生命。本研究旨在评估 3938 例因呼吸道感染入住 Cheil 综合医院和妇女保健中心患儿低钠血症的发生率及危险因素。收集临床资料,对各种微生物进行多重 RT-PCR 分析。531 例(13.5%)患儿出现低钠血症。低钠血症发生率与呼吸道感染(P<0.0001)和微生物(P=0.001)有关。低钠血症患儿入院年龄显著较大(P<0.0001),男性更多(P=0.019),C 反应蛋白(CRP)更高(P<0.0001),合并多种病原体感染更常见(P=0.001)。多变量分析显示,入院年龄较大(P=0.006)、男性(P=0.004)、CRP 升高(P<0.0001)是独立危险因素。血清钠水平与白细胞(WBC)(P=0.037)、CRP(P<0.0001)和住院天数(P=0.020)呈负相关。年龄(AUC 值为 0.586,P<0.0001)、CRP(AUC 值为 0.599,P<0.0001)和血尿素氮(AUC 值为 0.559,P<0.0001)的 AUC 值均为低钠血症的显著预测因子。本研究首次表明,低钠血症的发生率与感染微生物和影像学表现有关。

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