麻疹患儿并发急性呼吸窘迫综合征的危险因素

裴亮, 文广富, 宋文良, 杨妮, 刘春峰

中国当代儿科杂志 ›› 2015, Vol. 17 ›› Issue (3) : 245-248.

PDF(1191 KB)
HTML
PDF(1191 KB)
HTML
中国当代儿科杂志 ›› 2015, Vol. 17 ›› Issue (3) : 245-248. DOI: 10.7499/j.issn.1008-8830.2015.03.009
论著·临床研究

麻疹患儿并发急性呼吸窘迫综合征的危险因素

  • 裴亮, 文广富, 宋文良, 杨妮, 刘春峰
作者信息 +

Risk factors for the development of acute respiratory distress syndrome in children with measles

  • PEI Liang, WEN Guang-Fu, SONG Wen-Liang, YANG Ni, LIU Chun-Feng
Author information +
文章历史 +

摘要

目的 探讨麻疹患儿并发急性呼吸窘迫综合征(ARDS)的危险因素。方法 回顾性分析PICU救治的55 例麻疹患儿的临床资料,其中11 例并发ARDS。采用单因素分析和非条件logistic 多因素回归分析筛选ARDS 发病的危险因素。结果 单因素分析显示,ARDS 组和非ARDS 组患儿入院时吸氧方式(鼻导管/面罩)、合并脓毒症比例、血C 反应蛋白(CRP)水平及淋巴细胞计数差异有统计学意义(P<0.05)。多因素logistic回归分析显示合并脓毒症和血CRP 水平增高是麻疹并发ARDS 的主要危险因素(OR 分别为116.444、1.050,P<0.05)。结论 合并脓毒症及血CRP 水平增高的麻疹患儿并发ARDS 的风险增加。

Abstract

Objective To study the risk factors for the development of acute respiratory distress syndrome (ARDS) in children with measles. Methods The clinical data of 55 children with measles were retrospectively studied. Of the 55 children, 11 were complicated by ARDS. The risk factors for the development of ARDS were investigated by univariate analysis and multivariate non-conditional logistic regression analysis. Results The univariate analysis showed that there were significant differences in the oxygen inhalation mode (nasal catheter/mask), the rate of sepsis, blood C-reactive protein (CRP) levels and lymphocyte counts at admission between the ARDS and non-ARDS groups (P<0.05). The presence of sepsis and higher blood CRP levels were identified as the major risk factors for the development of ARDS by the multivariate logistic regression analysis (OR=116.444, 1.050 respectively; P<0.05). Conclusions The children with measles who have sepsis and higher blood CRP levels are at risk of ARDS.

关键词

麻疹 / 急性呼吸窘迫综合征 / 危险因素 / 儿童

Key words

Measles / Acute respiratory distress syndrome / Risk factor / Child

引用本文

导出引用
裴亮, 文广富, 宋文良, 杨妮, 刘春峰. 麻疹患儿并发急性呼吸窘迫综合征的危险因素[J]. 中国当代儿科杂志. 2015, 17(3): 245-248 https://doi.org/10.7499/j.issn.1008-8830.2015.03.009
PEI Liang, WEN Guang-Fu, SONG Wen-Liang, YANG Ni, LIU Chun-Feng. Risk factors for the development of acute respiratory distress syndrome in children with measles[J]. Chinese Journal of Contemporary Pediatrics. 2015, 17(3): 245-248 https://doi.org/10.7499/j.issn.1008-8830.2015.03.009

参考文献

[1] Perry RT, Gacic-Dobo M, Dabbagh A, et al. Global control and regional elimination of measles, 2000-2012 [J]. MMWR Morb Mortal Wkly Rep, 2014, 63(5): 103-107.
[2] Asaria P, MacMahon E. Measles in the United Kingdom: can we eradicate it by 2010?[J]. BMJ, 2006, 333(7574): 890-895.
[3] Abramson O, Dagan R, Tal A, et al. Severe complications of measles requiring intensive care in infants and young children[J]. Arch Pediatr Adolesc Med, 1995, 149(11): 1237- 1240.
[4] Weber I, Bouaziz JD, Wolkenstein P, et al. Respiratory distress with radiographic pleural effusion during measles virus infection[J]. J Eur Acad Dermatol Venereol, 2010, 24(1): 113- 114.
[5] Piastra M, Onesimo R, De Luca D, et al. Measles-induced respiratory distress, air-leak and ARDS[J]. Eur J Clin Microbiol Infect Dis, 2010, 29(2): 181-185.
[6] 卫生部政策法规司. WS296-2008 麻疹诊断标准[S]. 北京: 人 民卫生出版社, 2009.
[7] Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome: the Berlin Definition[J]. JAMA, 2012, 307(23): 2526-2533.
[8] Goldstein B, Giroir B, Randolph A. International Pediatric Sepsis Consensus Conference: Definitions for Sepsis and Organ Dysfunction in Pediatrics[J]. Pediatr Crit Care Med, 2005, 6(1): 2-8.
[9] Abdulkarim A, Johnson A, Yahaya-Kongoila S, et al. Measles:the past, the present and the future[J]. Niger J Paed, 2012, 39(3): 144-148.
[10] Qaisar I, Ahmad A, Ahmad F, et al. Comparison of measles complications in well-nourished and mal-nourished children[J]. J Ayub Med Coll Abbottabad, 2009, 21(2): 30-31.
[11] Aaby P, Samb B, Simondon F, et al. Non-specific beneficial effect of measles immunisation: analysis of mortality studies from developing countries[J]. BMJ, 1995, 311(7003): 481-485.
[12] Lim TA, Marinova L, Kojouharova M, et al. Measles outbreak in Bulgaria: poor maternal educational attainment as a risk factor for medical complications[J]. Eur J Public Health, 2013, 23(4): 663-669.
[13] Perry RT, Halsey NA. The clinical significance of measles: a review[J]. J Infect Dis, 2004, 189(Suppl 1): 4-16.
[14] Rafat C, Klouche K, Ricard JD, et al. Severe measles infection: the spectrum of disease in 36 critically ill adult patients[J]. Medicine(Baltimore), 2013, 92(3): 257-272.
[15] Phua J, Badia JR, Adhikari NK, et al. Has mortality from acute respiratory distress syndrome decreased over time?: A systematic review[J]. Am J Respir Crit Care Med, 2009, 179(3): 220-227.
[16] Stawicki SP, Goyal M, Sarani B . High-frequency oscillatory ventilation (HFOV) and airway pressure release ventilation(APRV): a practical guide[J]. J Intensive Care Med, 2009, 24(4): 215-229.
[17] Wada T, Jesmin S, Gando S, et al. The role of angiogenic factors and their soluble receptors in acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) associated with critical illness[J]. J Inflamm (Lond), 2013, 10(1): 6.
[18] 喻文亮, 陆铸今, 王莹, 等. 小儿ARDS 前瞻性多中心临床 流行病学研究[J]. 中华急诊医学杂志, 2005, 14(6): 448-453.
[19] Lobo SM, Lobo FR, Bota DP, et al. C-reactive protein levels correlate with mortality and organ failure in critically ill patients[J]. Chest, 2003, 123(6): 2043-2049.
[20] Bajwa EK, Khan UA, Januzzi JL, et al. Plasma C-reactive protein levels are associated with improved outcome in ARDS[J]. Chest, 2009, 136(2): 471-480.
[21] 陈雪峰, 李小民, 刘克喜, 等. C 反应蛋白测定对ARDS 的早 期诊断价值[J]. 世界急危重病医学杂志, 2004, 1(5): 354-355.

PDF(1191 KB)
HTML

Accesses

Citation

Detail

段落导航
相关文章

/