ABSTRACT
Objective To investigate the high risk factors for wheezing of low birth weight premature infants with wheezing.Methods A cohort study of 143 premature infants,whose gestation less than 37 weeks and birth weight less than 2 500 g,were collected from Neonatal Intensive Care Unit of Kunming Children's Hospital,from December 2012 to November 2013.Follow-up investigation was conducted,and those with wheezing were enrolled in the study.Many possible factors causing wheezing were analyzed,such as general conditions in the neonatal period,family conditions,and treatment.SPSS 17.0 statistical software was used to analyze the data.Single factor analysis was used by x2 test and rank sum test to evaluate the possible risk factors.Multiple factors analysis was made by Logistic regression analysis.P ＜ 0.05 was viewed as having statistical difference.Results (1) The risk factors for wheezing in the premature infants were:continuous positive airway pressure (CPAP) noninvasive ventilation (x2 =8.531,P =0.003),ventilation (x2 =4.800,P =0.028),caesarean section (x2 =6.787,P =0.009),the use of pulmonary surfactant (x2 =5.455,P =0.020),using antibiotics used at hospital (x2 =5.192,P =0.023),father smoking(x2 =5.406,P =0.020),maternal smoking (x2 =8.531,P =0.003),maternal allergic history (x2 =8.297,P =0.004),compatriot history of allergies (x2 =8.297,P =0.004) or asthma (x2 =9.774,P =0.002),family environment with dust and excitant gas (x2 =12.831,P =0.000) were the risk factors for the wheezing in the low birth weight premature infants.(2)Multi-factor classification Logistic regression analysis showed that CPAP (OR =58.414,95 ％ CI:3.317-1 028.646,P =0.005),mother smoking during pregnancy (OR =11.953,95 ％ CI:1.309-109.120,P =0.028),compatriot history of allergies (OR=135.769,95％ CI:4.914-3 751.419,P =0.004),family environment(OR =83.738,95％ CI:4.416-1 587.982,P =0.003),were independent risk factors for wheezing in low birth weight premature infants;natural labor was protective factor for wheezing in low birth weight premature infants (OR =0.045,95％ CI:0.004-0.574,P =0.017).(3)The sensitivity and specificity of risk factors were analyzed.The highest sensitivity was estimated for the father's history of allergy(83.3％).The highest specificity was estimated for the use of antibiotics at hospital (76.7％).Conclusions The study shows that CPAP noninvasive ventilation,mother smoking during pregnancy,allergy history of their brothers and sisters,family environment with dust and excitant gas are independent risk factors for wheezing in the low birth weight premature infants.There is no single risk factor with both high sensitivity and high specificity.
ABSTRACT
Objective To explore the interleukin-4 (IL-4),interleukin-6 (IL-6),interferon-gamma (IFN-γ) levels in bronchoalveolar lavage fluid (BALF) of children with refractory mycoplasma pneumoniae pneumonia,and the features of bronchoscopy.Methods A total of 47 children with refractory mycoplasma pneumoniae pneumonia were selected as the observation group,28 children with bronchial foreign body in GAN zhengyan were chosen as controls during the same period.ELISA method was used to detect the IL-4,IL-6,IFN-γ levels in the BALF,and compared them in these two groups.The bronchoscope features of the observation group were observed.Results The IL-4,IL-6,IFN-γ levels in the BALF of children in the observation group were (8.3 ± 3.1) pg/mL,(62.3 ± 18.4) pg/mL,(76.5 ± 21.9) pg/mL,and they were significantly higher than those of the controls (3.1 ± 1.2) pg/m L,(30.0 ± 1.5) pg/m L,(31.3 ± 24.9) pg/mL (P ＜0.05,respectively).In the observation group,the bronchial mucosa congestion and edema were observed in all patients,there were variable amounts of mucus secretions.There were other changes include:microtubule reductus (68.1％),bronchial mucosal follicle-like hyperplasia (38.3％),mucosal erosions (8.5％),airway inflammatory stenosis,mucus plug blocking (59.6％),granulation proliferation (14.9％),bronchial obliteration (4.3％) Conclusions The IL-4,IL-6,IFN-γ levels in the BALF of children with RMPP significantly increased.This indicates a significant local inflammatory response in children with RMPP.Mycoplasma pneumoniae pneumonia (MPP) has certain features of bronchoscope,these features are helpful to the diagnosis and treatment of MPP.
ABSTRACT
Objective To determine the serum 25 hydroxy vitamin D3[25(OH)D3]levels in chil-dren with bronchial asthma and its relationship with lung function,fraction of exhaled nitric oxide( FeNO). Methods Totally 112 children with asthma aged 6 years to 14 years old were selected as the study group, meanwhile 78 healthy children aged 6 years to 14 years old were selected as the control group,serum 25 ( OH)D3 was determined using the electrochemical luminescence method. Lung function was measured, which included peak expiratory flow( PEF),forced expiratory volume in one second( FEV1 ),percentage of PEF in predicted value( PEF% pred),percentage of FEV1 in predicted value( FEV1% pred). FeNO of the study group was measured. The relationship between serum 25( OH)D3 and PEF% pred,FEV1% pred,FeNO were all analyzed. Results The proportion of vitamin D deficiency and insufficiency in the study group were higher than those in the control group(χ2 =7. 78,P﹤0. 01). The values of PEF% pred and FEV1% pred were decreased with the decreasing of the 25(OH)D3 levels(F=28. 12,29. 56,P﹤0. 05),FeNO values were in-creased with the decreasing of the 25(OH)D3 levels(F=15. 65,P﹤0. 05). Conclusion Vitamin D defi-ciency or insufficiency is related to asthma in children. It is associated with the decrease of lung function,and can increase the level of airway inflammation in children with asthma.