摘要目的 探讨肥胖及超体质量对普通肺炎患儿平均住院时间及总病程的影响.方法 共有455例2～7岁普通肺炎患儿纳入本研究,包括147例肥胖儿童、141例超体质量儿童以及167例正常体质量儿童.然后根据年龄进一步分为≥2～4岁年龄组和≥4 ～7岁年龄组.通过查阅病历管理系统,收集患儿资料,包括性别、年龄、体质量、身高、住院时间、总病程、外周血细胞计数(白细胞、中性粒细胞、单核细胞及淋巴细胞)、C反应蛋白(CRP)、红细胞沉降率(ESR)、体液免疫指标(IgG、IgA)、细胞免疫指标(CD4+T、CD8+T)及反复肺炎病史.结果 在≥2 ～4岁年龄组,肥胖及超体质量儿童的平均住院时间均较正常体质量儿童长(P=0.037、0.009),肥胖儿童的总病程也较正常体质量儿童延长(P=0.014);在≥4 ～7岁年龄组,肥胖及超体质量儿童的平均住院时间及总病程均较正常体质量儿童长(平均住院时间:P=0.002、0.000;总病程:P=0.004、0.001).在≥2 ～4岁年龄组,肥胖、超体质量及正常体质量儿童外周血细胞计数、CRP、ESR、IgG、IgA、CD4+T、CD8+T、CD4+T/CD8+T及反复肺炎病史差异均无统计学意义(P均＞0.05);在4～7岁年龄组,肥胖及超体质量及正常体质量儿童外周血细胞计数、ESR比较差异均无统计学意义(P均＞0.05).但肥胖、超体质量儿童体液(IgG)及细胞免疫指标(CD4+T、CD4+ T/CD8+ T)均较正常体质量儿童下降,肥胖儿童表现更为明显,并且肥胖及超体质量儿童更易患反复肺炎(P＜0.05).结论 ≥2 ～7岁肥胖及超体质量的普通肺炎儿童较正常体质量儿童需要更长的住院时间,其肺炎总病程也相对延长.免疫功能受损在≥4 ～7岁年龄组患儿中发挥主要作用,而在≥2 ～4岁年龄组中,非免疫因素可能起主要作用.

abstractsObjective To study the effect of obesity and overweight on the hospital stays and total course of common pneumonia in children and the possible reasons.Methods A total of 455 children with common pneumonia aged from 2 to 7 years were enrolled in this study,including 147 obese children,141 overweight children and 167 normal weight children.Then all the children were divided into 2 groups based on age:≥ 2-4 years group and ≥ 4-7 years group.The information of the patients was collected from the medical records management system of our hospital,and including gender,age,weight,height,hospital stays,total course,peripheral blood cell counts (white blood cell,neutrophil,monocyte and lymphocyte),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),IgG,IgA,CD4 + T,CD8 +T and the history of recurrent pneumonia.Results In ≥ 2-4 years group,the average length of the hospital stays of common pneumonia in obese and overweight children was longer than that in the normal weight children(P =0.037,0.009),and the total course of common pneumonia in obese children was longer than that in the normal weight children (P =0.014).In ≥ 4-7 years group,the average length of the hospital stays and total course of common pneumonia in obese and overweight children were longer than those in the normal weight children (the hospital stay:P =0.002,0.000,the total course:P =0.004,0.001).In ≥2-4 years group,the peripheral blood cell counts(white blood cell,neutrophil,monocyte and lymphocyte),CRP,ESR,IgG,IgA,CD4 + T,CD8 + T,CD4 + T/CD8 + T and the history of recurrent pneumonia were of no significant difference among obese,overweight and normal weight children (all P ＞0.05).In ≥4-7 years group,the peripheral blood cell counts(white blood cell,neutrophil,monocyte and lymphocyte),and ESR were of no significant difference among obese,overweight and normal weight children (all P ＞ 0.05),but the levels of IgG,CD4 + T and CD4 + T/CD8 + T in obese and overweight children were lower than those in the normal weight children,and the obese children were more notable in this aspect (P ＜ 0.05).And obese and overweight children were more likely to suffer from recurrent pneumonia.Conclusions Obese and overweight children with common pneumonia aged from 2 to 7 years may need longer hospital stay and total course than normal weight children.Impaired immunity may be the main reason for the ≥4-7 years group,but in the ≥2-4 years old group,it may be attribute to some non-immune factors.