摘要
目的探究不同年龄段的社区获得性肺炎患儿舌下微循环数据特征。方法回顾性分析中国人民解放军总医院第七医学中心附属八一儿童医院2018年9月-2019年9月接受舌下微循环数据采集的41例社区获得性肺炎患儿的病历资料。按年龄将患儿分为学龄前组19例(1~6岁)及学龄组22例(7~14岁),对比分析两组儿童生长发育指标(年龄、身高、体质量、体质量指数)、大循环指标(经皮血氧饱和度、心率、血压、体温)与微循环指标[De Backer指数(De Backer score,DBs)、变异指数(hetergeneity index,HI)、小血管变异指数(hetergeneity index small,HIs)、灌注血管比例(proportion of pefused vessels,PPV)、小血管灌注血管比例(proportion of pefused small vessels,PPVs)、平均血流速度(averange velocity,AV)、小血管平均血流速度(averange velocity small,AVs)、总血管密度(total of vessel density,TVD)、灌注血管密度(pefused vessel density,PVD)、灌注小血管密度(pefused small vessel density,PVDs)]特征,组间比较采用t检验或Mann-Whitney秩和检验,相关性分析采用Pearson相关系数分析及单因素线性回归分析。结果纳入研究的患儿共41名,平均年龄为(6.6±2.6)岁,年龄最小为14个月,最大为14岁,男童占48.8%,女童占51.2%。学龄前组与学龄组的体温差异无统计学意义(P>0.05),学龄前组心率高于学龄组,而收缩压、舒张压、平均动脉压(MAP)低于学龄组,差异有统计学意义(P<0.01),两组SpO2均为100%。学龄前组的HI及HIs高于学龄组,差异有统计学意义(P<0.01);其余微循环指标DBs、PPV、PPVs、AV、AVs、TVD、PVD、PVDs等,差异均无统计学意义(P>0.05)。将患儿微循环指标与年龄、BMI、体温、心率、收缩压、舒张压、MAP等指标进行相关性分析,可得出患儿HI及HIs与年龄的相关性有统计学意义(P<0.01),其相关系数r分别为-0.420、-0.435,呈中度负相关。其余指标的相关性分析,均无统计学意义。结论不同年龄段的社区获得性肺炎患儿大循环数据存在差异,而患儿微循环灌注水平并无明显差异;学龄前组的微循环变异度(HI及HIs)高于学龄组。
Objective To explore the characteristics of sublingual microcirculation in children with community acquired pneumonia(CAP)in different age groups.Methods The medical records including sublingual microcirculation of 41 children with CAP in the Bayi Children’s Hospital affiliated to the seventh medical center of Chinese PLA General Hospital from September 2018 to September 2019 were retrospectively analyzed.According to age,the children were divided into preschool children(age ranging from 1-6 years)and school-age children(age ranging from 7-14 years),characteristics of growth and development index,macrocirculation index and microcirculation index were compared between the two groups.T test or mann-whitney rank sum test were used for inter-group comparison,Pearson correlation coefficient analysis was used for correlation analysis.Results A total of 41 children were included in the study,with an average age of(6.6±2.6)years old,ranging from 14 months to 14 years,with male accounting for 48.8%and female for 51.2%.The difference in body temperature and peripheral capillary oxygen saturation(SpO2)between the two groups was not statistically significant(P>0.05),while the school-age children had statistically significant lower heart rate,and higher systolic blood pressure,diastolic blood pressure and mean arterial pressure compared to the preschool children(all P<0.01).The hetergeneity index(HI)and hetergeneity index small(HIs)of preschool group was higher than that of the school-age group and the differences were statistically significant(P<0.01,respectively).Other microcirculation indexes(DBs,PPV,PPVs,AV,AVs,TVD,PVD,PVDs)showed no statistically significant difference(P>0.05).Correlation analysis of microcirculation index with age,BMI,body temperature,heart rate,systolic blood pressure,diastolic blood pressure and mean arterial pressure in the children showed that HI and HIs of the children was significantly correlated with age(P<0.05).Their correlation coefficients r were-0.420 and-0.435,respectively,indicating a moderate negative correlation,while other indexes showed no significant difference.Conclusion The differences of macrocirculatory index in children with CAP at different age do not affect the level of microcirculatory perfusion.Sublingual microcirculation of HI and His is higher in preschool children than in school-age children.
作者
王猛
许煊
WANG Meng;XU Xuan(Chinese PLA Medical School,Beijing 100853,China;Bayi Children's Hospital Affiliated to the Seventh Medical Center,Chinese PLA General Hospital,Beijing 100700,China)
出处
《解放军医学院学报》
CAS
2020年第5期526-531,共6页
Academic Journal of Chinese PLA Medical School
关键词
儿童
社区获得性肺炎
舌下微循环
旁流暗视野
children
community acquired pneumonia
sublingual microcirculation
sidestream dark field
