ABSTRACT
Objective@#To investigate the risk factors for pneumonia in children with Epstein-Barr virus (EBV) infectious mononucleosis(IM).@*Methods@#The clinical data of children with EBV-IM from March 2015 to February 2018 in Children′s Hospital of Chongqing Medical University were retrospectively analyzed.The patients were divided into a pneumonia group and a non-pneumonia group.The difference between 2 groups was analyzed, including gender, age, duration of fever, the maximum temperature in disease duration, the size of liver, the size of spleen, tonsillopharyngitis, cervical lymphadenopathy, edema of the eyelids, white blood cell (WBC), lymphocyte, atypical-lymphocytes, C-reactive protein (CRP), procalcitonin (PCT), alanine transaminase (ALT), glutamic oxalacetic transaminas (AST), lactic dehydrogenase (LDH), cytomegalovirus (CMV) antibody, the titer of mycoplasma (MP) antibody, EBV DNA, length of stay, and hospitalization expenses.The single factor analysis was performed to analyze the above data between 2 groups, and the data with statistical significance were analyzed by the multifactor Logistic regression.The recei-ver operator characteristic (ROC) curve was drawn to evaluate the predicting ability of the indicators for IM combined with pneumonia.@*Results@#Among 923 cases, 133 cases(14.4%) EBV-IM patients were complicated with pneumonia.The findings of single factor analysis indicated that the risk factors were the duration of fever, the size of liver, the size of spleen, and the titer of MP antibody (all P<0.05). The multifactor Logistic regression showed that the duration of fever, the size of liver, the titer of MP antibody were the risk factors for EBV-IM children with pneumonia (P=0.013, 0.028, 0.014). The area under curve (AUC) of the duration of fever was 0.624, and the critical value was 7.5 d (P=0.000); the AUC of the size of liver was 0.590, and the critical value was 2.65 cm (P=0.003).@*Conclusions@#The incidence rate of EBV-IM children combined with pneumonia was high.With the presence of the titer of MP antibody ≥1∶160, the duration of fever≥7.5 days, and the size of liver>2.65 cm, it may be independent risk factors for pneumonia in IM children with EBV infection, which requires special attention clinically and earlier chest imageological examination are needed.
ABSTRACT
Objective To investigate the risk factors for pneumonia in children with Epstein-Barr virus (EBV) infectious mononucleosis(IM).Methods The clinical data of children with EBV-IM from March 2015 to February 2018 in Children's Hospital of Chongqing Medical University were retrospectively analyzed.The patients were divided into a pneumonia group and a non-pneumonia group.The difference between 2 groups was analyzed,including gender,age,duration of fever,the maximum temperature in disease duration,the size of liver,the size of spleen,tonsillopharyngitis,cervical lymphadenopathy,edema of the eyelids,white blood cell (WBC),lymphocyte,atypical-lymphocytes,C-reactive protein (CRP),procalcitonin (PCT),alanine transaminase (ALT),glutamic oxalacetic transaminas (AST),lactic dehydrogenase (LDH),cytomegalovirus (CMV) antibody,the titer of mycoplasma (MP) antibody,EBV DNA,length of stay,and hospitalization expenses.The single factor analysis was performed to analyze the above data between 2 groups,and the data with statistical significance were analyzed by the multifactor Logistic regression.The receiver operator characteristic (ROC) curve was drawn to evaluate the predicting ability of the indicators for IM combined with pneumonia.Results Among 923 cases,133 cases(14.4％) EBV-IM patients were complicated with pneumonia.The findings of single factor analysis indicated that the risk factors were the duration of fever,the size of liver,the size of spleen,and the titer of MP antibody (all P ＜ 0.05).The multifactor Logistic regression showed that the duration of fever,the size of liver,the titer of MP antibody were the risk factors for EBV-IM children with pneumonia (P =0.013,0.028,0.014).The area under curve (AUC) of the duration of fever was 0.624,and the critical value was 7.5 d (P =0.000);the AUC of the size of liver was 0.590,and the critical value was 2.65 cm (P =0.003).Conclusions The incidence rate of EBV-IM children combined with pneumonia was high.With the presence of the titer of MP antibody ≥ 1:160,the duration of fever ≥7.5 days,and the size of liver ＞ 2.65 cm,it may be independent risk factors for pneumonia in IM children with EBV infection,which requires special attention clinically and earlier chest imageological examination are needed.
ABSTRACT
Objective To investigate the efficacy and safety of montelukast sodium combined with fluticasone propionate in treatment of children with cough variant asthma.Methods Two hundred and forty children diagnosed as cough variant asthma in our hospital during February 2013 to January 2015 were randomized into three groups.Children in group Mon + Flu were given montelukast sodium combined with inhaled fluticasone propionate,children in group Flu was given inhaled corticosteroids alone and children in group Mon was given montelukast sodium alone.Cough,lung function and adverse reactions were observed after 8 and 12 weeks of treatment and the recurrences of cough symptoms were followed up within 24 weeks.Results After 8 weeks of treatment,the score of cough in group Mon + Flu (1.1 ± 0.7) was lower than those in groups Flu (1.7 ±0.8) and Mon (1.6 ±0.8) (t =4.973,4.353,P ＜0.05),while there was no significant difference between group Flu and group Mon(t =0.560,P ＞ 0.05).Meantime,the percentage of predicted in FEV1 in group Mon+ Flu (93.4 ± 15.8) was significantly higher than those in group Flu (87.4 ± 11.0) and group Mon (86.5 ± 9.8) (t =2.804,3.315,P ＜ 0.05).The percentage of predicted in PEF in group Mon + Flu(89.8 ± 15.4)was significantly higher than those in group Flu(84.9 ± 13.4)and group Mon(85.1 ± 12.3) (t =2.126,2.124,P ＜ 0.05),and there was no significant difference between latter two groups (t =0.525,0.082,P ＞ 0.05).After 12 weeks of treatment,there was no significant difference in scores of cough and percentage of predicted in FEV1 and PEF among three groups (P ＞ 0.05).There was no significant difference in incidence of adverse reactions among three groups (x2 =1.026,P ＞ 0.05).The recurrence rate of group Mon + Flu (3.85％) and group Flu(5.26％) were significantly lower than that of group Mon (17.33％) (x2 =7.428,5.505,P ＜ 0.05),while there was no difference between groups Mon + Flu and Flu (P ＞ 0.05).Conclusions For children with cough variant asthma montelukast sodium combined with fluticasone propionate has better efficacy than monotherapy in 8 weeks of treatment,but there was no difference in 12 weeks of treatment.The recurrence rate in group Mon + Flu and group Flu is lower than that in group Mon.