發(fā)布時(shí)間：2018-03-19 08:45

  本文選題：急性毛細(xì)支氣管炎　切入點(diǎn)：危險(xiǎn)因素　出處：《大連醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：背景:急性毛細(xì)支氣管炎是世界各地的嬰幼兒最�；嫉囊环N呼吸道疾病。許多危險(xiǎn)因素影響其發(fā)病率,父母及醫(yī)護(hù)工作者對(duì)其的關(guān)注每年都在增加。維生素A、D和E在維護(hù)機(jī)體生物學(xué)功能方面起到重要的作用。這些維生素有免疫調(diào)節(jié)作用,因此它們的缺乏可以導(dǎo)致各種疾病,尤其是呼吸道疾病。目前認(rèn)為維生素A、D、E對(duì)急性毛細(xì)支氣管炎有影響,所以本次研究中,比較了不同的因素及其與維生素A、D和E的關(guān)系,并試圖為臨床醫(yī)生提供重要的預(yù)測(cè)價(jià)值。本研究的價(jià)值在于發(fā)現(xiàn)維生素A、D和E對(duì)于急性毛細(xì)支氣管炎的作用和其相關(guān)危險(xiǎn)因素。因此,為這些孩子提供一個(gè)治療和預(yù)防維生素缺乏的方法。目的:在這項(xiàng)研究中,我們對(duì)6個(gè)月到3歲的急性毛細(xì)支氣管炎兒童進(jìn)行了多個(gè)風(fēng)險(xiǎn)因素的分析,包括性別、母乳喂養(yǎng)史,早產(chǎn)史、出生季節(jié)和維生素A、D、E水平。本研究將會(huì)為醫(yī)生提供減少急性毛細(xì)支氣管炎發(fā)病率的方法,并積極補(bǔ)充缺乏的維生素作為早期預(yù)防的手段。材料與方法:實(shí)驗(yàn)組115例(毛細(xì)支氣管炎組,沒有其他重大的潛在疾病)和114例未感染細(xì)支氣管炎或其他呼吸道疾病(對(duì)照組,沒有重大的潛在疾病),病例來自于2015年1月至2017年1月在大連醫(yī)科大學(xué)第一附屬醫(yī)院兒科住院和門診就診的兒童,研究比較了維生素A、D、E水平、急性毛細(xì)支氣管炎相關(guān)風(fēng)險(xiǎn)因素的統(tǒng)計(jì)學(xué)意義。應(yīng)用spss 21.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)分析。對(duì)連續(xù)變量進(jìn)行均值和標(biāo)準(zhǔn)差描述,分類變量進(jìn)行百分比描述。T檢驗(yàn)比較兩個(gè)獨(dú)立樣本的關(guān)系。χ2檢驗(yàn)比較分類變量的關(guān)系。單因素方差分析用來比較季節(jié)和血清維生素A、D和E水平的關(guān)系。此外,應(yīng)用多因素分析比較特定季節(jié)血清維生素D水平的統(tǒng)計(jì)學(xué)意義。多因素線性回歸分析分別比較實(shí)驗(yàn)組、對(duì)照組特定年齡、性別血清水平的維生素A、D、E和毛細(xì)支氣管炎相關(guān)危險(xiǎn)因素的(妊娠、母乳喂養(yǎng)持續(xù)時(shí)間和季節(jié))關(guān)系。p0.05有統(tǒng)計(jì)學(xué)意義。結(jié)果:1.毛細(xì)支氣管炎組和非毛細(xì)支氣管炎組之間的比較血清維生素A平均濃度為0.29±0.15mg/L、維生素D為19.77±5.80 ng/L、維生素E為6.30±1.89 mg/L,病例組和對(duì)照組在季節(jié)(χ2=5.344;p0.001),母乳喂養(yǎng)(χ2=4.262;p=0.039)和妊娠方面(χ2=7.316;p=0.007),差異有統(tǒng)計(jì)學(xué)意義。同時(shí),這項(xiàng)研究顯示,兩組的血清維生素A(t=-6.683;p=0.000)和維生素D(t=3.388;p=0.001)水平差異有統(tǒng)計(jì)學(xué)意義。然而,兩組血清維生素E(t=-1.015;p=0.311)水平差異無統(tǒng)計(jì)學(xué)意義。2.維生素A、D和E獨(dú)立危險(xiǎn)因素的分析a)急性細(xì)支氣管炎患兒中,母乳喂養(yǎng)不足6個(gè)月患兒的血清維生素A水平顯著低于母乳喂養(yǎng)超過6個(gè)月的患兒(t=5.344;p=0.000)。母乳喂養(yǎng)時(shí)間相同時(shí),對(duì)照組血清視黃醇水平高于病例組,但差異無統(tǒng)計(jì)學(xué)意義(t=1.399;p=0.165)。b)只有在毛細(xì)支氣管炎患者中,血清維生素D水平與季節(jié)有關(guān)(χ2=12.736;p=0.001)。疾病組的四季維生素D水平差異有統(tǒng)計(jì)學(xué)意義。本研究結(jié)果顯示,急性毛細(xì)支氣管炎患者的維生素D水平,冬季(45.2%)高于春季(25.2%)高于夏天(17.4%)高于秋天(12.2%)。但在對(duì)照組中差異無統(tǒng)計(jì)學(xué)意義。c)從我們的研究結(jié)果顯示,兩組血清維生素E水平在性別、季節(jié),母乳喂養(yǎng)方面差異無統(tǒng)計(jì)學(xué)意義。3.維生素A、D和E多風(fēng)險(xiǎn)因素分析a)在病例組,只有母乳喂養(yǎng)少于6個(gè)月(β=-0.500;p0.001)的患兒喂養(yǎng)時(shí)間和血清維生素A水平呈負(fù)相關(guān)。同時(shí),在對(duì)照組中,年齡、性別、孕期,母乳喂養(yǎng)、季節(jié)與血清維生素A濃度無關(guān)。b)在病例組中,季節(jié)(β=0.419;p0.05)與血清維生素D水平相關(guān)。在對(duì)照組中,血清維生素D濃度與年齡、性別、孕期、季節(jié)和母乳喂養(yǎng)無關(guān)。c)在病例組中,孕期(β=0.464;p=0.001)與兒童血清維生素E濃度相關(guān)。在對(duì)照組中,血清維生素E濃度與年齡、性別、季節(jié)、孕期和母乳喂養(yǎng)無關(guān)。結(jié)論:1.維生素A和D有急性毛細(xì)支氣管炎的重大關(guān)系。2.獨(dú)立危險(xiǎn)因素分析發(fā)現(xiàn)急性毛細(xì)支氣管炎與維生素A和維生素D水平相關(guān)。而多危險(xiǎn)因素分析發(fā)現(xiàn)這三種維生素(A、D、E)與急性細(xì)支氣管炎相關(guān)。3.補(bǔ)充這些維生素可以作為預(yù)防3歲以下兒童急性毛細(xì)支氣管炎發(fā)作的重要措施。
[Abstract]:Background: acute bronchiolitis is a respiratory disease around the world. Most infants often suffer from many risk factors affecting the incidence, parents and health care workers to its attention is increasing year by year. Vitamin A, D and E play an important role in maintaining the biological function of these vitamins can regulate. The lack of immunity, so they can lead to various diseases, especially respiratory diseases. The vitamin A, D, E of acute bronchiolitis have influence, so in this study, compare the different factors and vitamin A, D and E, and to provide an important predictive value for clinicians. The value of this research lies in the discovery of vitamin A, D and E for acute bronchiolitis and its related risk factors. Therefore, to provide a method for the prevention and treatment of vitamin deficiency for these children. Objective: in this study, we for 6 months to 3 years of acute bronchiolitis in children were analyzed, several risk factors including gender, breastfeeding history, preterm birth, birth season and vitamin A, D, E level. The study will provide methods to reduce the incidence of acute bronchiolitis as a doctor, and to supplement the lack of vitamins as a means of early prevention. Materials and methods: 115 cases of the experimental group (bronchiolitis group, no other major potential disease) and 114 cases without infection bronchitis or other respiratory diseases (control group, no significant underlying disease), from January 2015 to January 2017 in the case the First Affiliated Hospital of Dalian Medical University pediatric inpatient and outpatient children compared with vitamin A, D, E, acute bronchiolitis risk factors associated with statistical significance. The application of SPSS 21 Statistical software for statistical analysis of continuous variables. The mean and standard deviation of the percentage of description, description of.T test between two independent samples of the relationship between categorical variables. The relationship between these 2 classification variables. Single factor analysis of variance was used to compare the seasonal and serum vitamin A, D and E levels. In addition, multiple factors analysis of statistical significance between the specific seasonal levels of serum vitamin D. Multivariate linear regression analysis were compared between the experimental group and the control group of gender specific age, serum levels of vitamin A, D, E and bronchiolitis related risk factors (pregnancy, breastfeeding duration and seasonal) have statistical significance. Results: compared with.P0.05 the average serum vitamin A concentration between 1. bronchiolitis group and non bronchiolitis group was 0.29 + 0.15mg/L, 19.77 + 5.80 ng/L of vitamin D, vitamin E is 6.30 + 1.89 Mg/L, the case group and the control group in the season (2=5.344; p0.001), breastfeeding (2=4.262; p=0.039) and pregnancy (2=7.316; p=0.007), the difference was statistically significant. At the same time, this study shows that two groups of serum vitamin A (t=-6.683; p=0.000) and vitamin D (t=3.388 p=0.001); statistically significant difference level. However, the two groups of serum vitamin E (t=-1.015; p=0.311) no significant differences were found in.2. of vitamin A, analysis of independent risk factors D and E a) in children with acute bronchiolitis in children with insufficient breastfeeding for 6 months the serum vitamin A level was significantly lower than that of breastfeeding for more than 6 months of children (t=5.344; p=0.000). Breast feeding at the same time, the level of serum retinol group was higher than the case group, but the difference was not statistically significant (t=1.399; p=0.165).B) only in capillary bronchitis patients, serum levels of vitamin D associated with seasonal (x 2=12.736; p=0.001). There were statistically significant differences in four levels of vitamin D in disease group. The results of this study showed that patients with acute bronchiolitis vitamin D levels in winter (45.2%) than in spring (25.2%) is higher than that of summer (17.4%) was higher than in autumn (12.2%). But no significant difference in the control group on the.C display) from the results of our study, the serum vitamin E level in the two groups in gender, seasonal differences, breastfeeding was not statistically significant.3. of vitamin A, D and E analysis of risk factors of a) in the patient group, only breastfed for less than 6 months (P =-0.500; p0.001) was negatively correlated with feeding time and serum vitamin the level of A. At the same time, in the control group, age, sex, pregnancy, breast-feeding, the season has nothing to do with the serum concentration of vitamin A.B) in case group, season (beta =0.419; P0.05 D) associated with the levels of serum vitamin. In the control group, serum vitamin D concentration With the age, sex, pregnancy, breast-feeding season and independent.C) in case group, pregnancy (beta =0.464; p=0.001) associated with children's serum vitamin E concentration. In the control group, serum vitamin E concentration and age, sex, season, pregnancy and breastfeeding. Conclusion: 1. of vitamin A and D there are significant independent risk factors of acute.2. bronchiolitis of acute bronchiolitis with vitamin A and vitamin D levels. And the multiple risk factor analysis found that the three kinds of vitamins (A, D, E) associated with acute bronchiolitis.3. these vitamin supplements can be used as an important measure to prevent children under 3 years old with acute bronchitis attack.

【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R725.6

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