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确定严重细支气管炎的预测风险因素。

Determination of predictive risk factors for severe bronchiolitis.

机构信息

Department of Pediatrics, School of Medicine, Adıyaman University, Adiyaman, Turkey.

出版信息

Int J Clin Pract. 2021 Nov;75(11):e14760. doi: 10.1111/ijcp.14760. Epub 2021 Sep 8.

Abstract

BACKGROUND

The aim of this study was to determine the predictive risk factors for development of severe bronchiolitis in patients with acute bronchiolitis with no previous chronic disease.

METHODS

Four hundred forty children aged 1-24 months hospitalised with acute bronchiolitis, were examined between February 2018 and February 2019 in this prospective study.

RESULTS

Eighty-five cases were regarded as severe bronchiolitis and 355 as mild-moderate bronchiolitis. Statistically significant differences were observed between the severe and mild-moderate bronchiolitis groups in terms of weight-for-age z-scores, history of bronchiolitis, haemoglobin levels, and time elapsed between the onset of symptoms and admission. Weight-for-age z-scores, the mean time interval between the onset of symptoms and admission, and mean haemoglobin values were lower in the severe bronchiolitis group while the mean number of bronchiolitis attacks was higher than in the mild-moderate bronchiolitis group. Logistic regression analysis determined that a low weight-for-age z-score increased the risk of severe bronchiolitis development 0.56-fold (CI: 0.409-0.760), a short duration between the onset of symptoms and admission increased the risk 0.62-fold (CI: 0.519-0.735), a frequent history of bronchiolitis increased the risk 1.81-fold (CI: 1.135-2.968) and low haemoglobin levels increased the risk 0.72-fold (CI: 0.537-0.969).

CONCLUSION

Low weight-for-age z-scores, a short duration between the onset of symptoms and admission, a high number of previous attacks and low haemoglobin levels were identified as independent parameters of severe bronchiolitis development.

摘要

背景

本研究旨在确定无既往慢性疾病的急性细支气管炎患儿发展为重症细支气管炎的预测风险因素。

方法

在这项前瞻性研究中,对 2018 年 2 月至 2019 年 2 月间住院的 440 名 1-24 月龄患有急性细支气管炎的儿童进行了检查。

结果

85 例被视为重症细支气管炎,355 例为轻症-中度细支气管炎。在体重年龄 Z 评分、细支气管炎史、血红蛋白水平以及症状出现到入院的时间方面,重症细支气管炎组与轻症-中度细支气管炎组之间存在显著差异。重症细支气管炎组的体重年龄 Z 评分、症状出现到入院的平均时间间隔和平均血红蛋白值较低,而细支气管炎发作次数较多。logistic 回归分析确定低体重年龄 Z 评分使重症细支气管炎的发病风险增加 0.56 倍(CI:0.409-0.760),症状出现到入院的时间间隔较短使发病风险增加 0.62 倍(CI:0.519-0.735),频繁的细支气管炎史使发病风险增加 1.81 倍(CI:1.135-2.968),低血红蛋白水平使发病风险增加 0.72 倍(CI:0.537-0.969)。

结论

低体重年龄 Z 评分、症状出现到入院的时间间隔较短、既往发作次数较多和低血红蛋白水平是重症细支气管炎发生的独立预测参数。

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