目的 检测不同年龄段反复呼吸道感染(RRTI)患儿体内主要微/常量元素锌(Zn)、铁(Fe)、钙(Ca)的含量变化,探讨患儿发生RRTI与微/常量元素的相关性.方法 纳入≤6岁的RRTI患儿200例作为RRTI组.按年龄分为3个亚组:＜3岁组70例,～5岁组70例,～6岁组60例.同期选取门诊体检的年龄≤6岁儿童80例,作为对照组.应用BH-5100五通道原子吸收光谱仪检测微/常量元素Zn、Fe、Ca水平.比较不同年龄组患儿及与对照组Zn、Fe、Ca水平.结果 RRTI组与对照组间性别、年龄差异均无统计学意义(均P＞0.05);RRTI患儿Zn、Fe、Ca含量均明显低于健康对照组(均P＜0.05);＜3岁组患儿Zn、Fe含量明显低于其他各组,随着年龄增长,逐渐升高;～5岁患儿Zn、Fe降低仍较明显;Ca含量随着年龄增长,反而逐渐降低,以～6岁患儿Ca降低最明显,差异有统计学意义(P＜0.05).结论 RRTI患儿婴幼儿期Zn、Fe和Ca缺乏严重,随着年龄增长,缺Ca依然存在.Zn、Fe和Ca缺乏与RRTI密切相关,监测并纠正Zn、Fe和Ca缺乏可能有助于降低患儿RRTI的发病率.

Objective To observe the clinical characteristics of bacterial pneumonia children,and the changes of the serum levels of white blood cells(WBC),C-reactive protein(CRP) and procalcitonin(PCT) before and after anti-bacterial therapy,and to explore the predictive value in early diagnosis and therapy.Methods 130 bacterial pneumonia children were enrolled prospectively as pneumonia group.The clinical data were collected and the serum CRP,PCT and WBC were detected before anti-bacterial therapy (within 24h after admission) and after anti-bacterial therapy (the seventh day after admission).34 healthy children were enrolled as control group.The general clinical characteristics of the children in the pneumonia group were observed.The levels of serum CRP,PCT and WBC between the pneumonia group and the control group were compared.The levels of serum CRP,PCT and WBC before and after anti-bacterial therapy in the bacterial pneumonia children were compared.The clinical value of PCT,CRP and WBC in early predicting bacterial pneumonia was identified.Results Compared with the control group,the sex and age of the bacterial pneumonia children demonstrated no statistically significant differences (t =1.012,P =0.395;x2 =0.003,P =0.959).The mean course of the disease before admission was (5.34 ± 1.27) d,with mean temperature of (38.27 ± 0.96) ℃,and hospital days of (8.92 ± 3.93) d.35 cases were cured,and 95 cases were improved,with no death.The serum levels of CRP,PCT and WBC in pneumonia children on admission were (12.24 ±6.35) mg/L,(0.18 ± 0.15) ng/mL and (14.25 ± 7.59) 109/L,respectively,which were higher than those of the control group,the differences were statistically significant (t =4.650,5.867,2.548,all P ＜ 0.05).The serum levels of CRP,PCT and WBC in pneumonia children before anti-bacterial therapy were higher than after bacterial therapy,showed statistically significant differences(t =8.165,7.232,5.112,all P ＜ 0.05).The area under the curve (AUC)of the PCT,CRP and WBC in early predicting bacterial pneumonia were 0.928,0.834 and 0.718 respectively by the relative operating characteristic (ROC) curve analysis (P ＜ 0.05).The sensitivity and specificity of PCT in predicting bacterial pneumonia were higher than CRP and WBC.Conclusion The statistics efficacy of PCT in early predicting children bacterial infection was obviously higher than CRP and PCT.The combined detection of CRP,PCT and WBC was benefit to improve the diagnostic sensitivity and specificity of children with bacterial pneumonia.

目的 调查了解玉环县0～14岁儿童哮喘患病状况及相关影响因素,为儿童哮喘防治提供科学依据.方法 采用多阶段抽样方法,对1 100名哮喘儿童进行25项相关因素的流行病学调查,应用Logistic回归分析,筛选主要因素,得出相关变量的偏回归系数及优势比.结果 各年龄组儿童哮喘患病率差异无统计学意义(P＞0.05);首次发病年龄＜3岁的患儿最多,差异有统计学意义(P＜0.01);发作强度以中度最为常见(82.0％).发作类型以突然发作最多(92.4％);好发季节换季时最多(47.0％);觉发病诱因最主要是呼吸道感染(91.1％);临床症状主要为喘鸣、咳嗽、憋气、胸闷、呼吸延长和呼吸困难等.结论 哮喘与遗传及环境因素存在较大关联,应加强对儿童的各种保护措施,使其远离各种高危影响因素,保护玉环县儿童身体健康.

Objeetive To analyze the clinical significance of serial microproteinuria and urease detection in early diagnosis of antibiotics damage to kidney by observing the changes of urine microalbumin/creatinine ratio (mAlb/Cr),transferrin (TRF),IgG,α1-microglobulin (α1-M G),β2-microglobulin (β2-M G),retinol-binding pmtein(RBP) and N-acetyl-β-D-glucosaminidase(NAG).Methods A total of 161 children with pneumonia whose test results were normal of urine protein,blood urea nitrogen (BUN) and serum creatinine (Scr),and had no related history of kidney diseases were selected.All the patients were divided into three groups according to antibiotics for the treatment,the penicillins (penicillin G,amoxicillin and potassium clavulanate,ticarcillin and potassium clavulanate) group,the cephalosporins (cefazolin,cefuroxime,ceftriaxone,cefoperazone,ceftazidime) group and the macrolides (erythromycin,azithromycin) group.Changes of mAlb/Cr,TRF,IgG,α1-MG,β2-MG,RBP,NAG,BUN,Scr levels of the patients one week before and after use the antibiotics were observed,and statistically analyzed.Results In the penicillins group and macrolides group,the results showed that none of the serial microproteinuria and urease changed(all P ＞ 0.05).In the cephalosporins group,the urine mAlb/Cr,TRF,β2-MG and NAG were higher than before using the antibiotics [(15.56 ± 5.98) mg/g vs.(21.08 ± 10.88) mg/g,(1.61 ± 0,14)mg/L vs.(1.66 ±0.14) mg/L,(0.25 ±0.09)mg/L vs.(0.28 ±0.11)mg/L,(4.62 ±3.80) U/L vs.(4.98 ±3.97) U/L,t =-5.11,-3.24,-2.29,-2.04,P ＜ 0.05 ～ 0.001].The levels of BUN and Scr revealed no change in all the patients(all P ＞ 0.05).Conclusion Combined detection of serial microproteinuria and urease has great clinical significance in judgment and warning of early renal damage by antibiotics.

Objective: To explore the clinical curative effect of bifid triple viable combined with enema therapy in treatment of neonatal jaundice. Methods: One hundred and two normal full-term neonates with pathological jaundice were randomly divided into control group and treatment group,51 neonates in each group.The neonates in the two groups were treated with routine therapy,while on the basis of routine therapy,the neonates in treatment group were treated with oral administration of bifid triple viable(0.5 g) and enema therapy with normal saline(5-10 ml,39℃-41℃),three times a day.The changes of transdermal bilirubin concentration before treatment and at 1-4 days after treatment in the two groups were observed. Results: The total effective rate of treatment group was 94.12%,which was significantly higher than that of control group(84.31%)(P<0.05).After treatment,the bilirubin concentrations in the two groups after treatment decreased significantly(P<0.05),especially in treatment group(P<0.05). Conclusion: The curative effect of bifid triple viable combined with enema therapy is good in treatment of neonatal jaundice,and the method is worthy to be popularized.

<正>小儿急性肾炎又称急性肾小球肾炎,临床表现为血尿、水肿、高血压、蛋白尿等,常发于5～14岁小儿,居泌尿系统疾病患儿住院率的首位。笔者采用复可托联合玉屏风颗粒辅助治疗小儿急性肾炎患者53例,取得良好疗效,报道如下。1临床资料

过敏性紫癜(HSP)是一种儿科常见病,近年来发病率有增加趋势.目前,关于HSP的治疗方法较多,但并无特效疗法.我院采用卡介菌多糖核酸注射液治疗HSP,取得了较好疗效,现报道如下.

急性毛细支气管炎是婴幼儿常见的下呼吸道感染性疾病,本病仪见于2岁以内的小儿,高峰发病年龄是6个月左右的婴儿.据文献报道,约30%的患儿会发展成哮喘,且近年来有上升趋势[1].我们自2004年2月至2007年10月应用普米克令舒、博利康尼联合沐舒坦氧气驱动雾化吸入,治疗婴幼儿急性毛细支气管炎,取得较好效果,现报道如下.

目的 观察应用小剂量甲基强的松龙静脉滴注联合肝素雾化吸入对小儿支气管哮喘的疗效.方法 对收治的支气管哮喘患儿60例分治疗组和对照组.每组30例.两组患儿年龄性别临床表现及入院前病程基本相同,经统计学处理,P＞0.05,差异无显著性意义.两组患儿一般治疗采用均给予抗感染及平喘补液对症处理,治疗组给予甲基强的松龙1～2mg/kg加入10%GS 50m1,每6～8 h静滴1次,共3d,同时每次给予肝素100u/kg雾化吸入,每日2次,连用3d.结果 治疗组在止咳平喘,肺部罗音消失,平均住院日优于对照组,P＜0.01,差异有显著性意义.结论 小剂量甲基强的松龙静脉滴注联合肝素雾化吸人对小儿支气管哮喘能及时缓解喘息症状,缩短病程具有良好效果.