【摘要】 目的 针对哮喘患儿，分析免疫功能对哮喘发病及预后的影响。方法 纳入2018年1月至2021年1月期间青海省妇女儿童医院接诊的148例确诊的哮喘患儿，测定患儿免疫功能情况，收集全部患儿随访治疗后6个月的信息；对比免疫功能低下与免疫功能正常患儿的发病及随访预后情况，分析讨论免疫球蛋白(IgG、IgA、IgM)表达水平与患儿发病及短期复发预后(6个月)之间的关联，以便指导预防与临床工作。结果 148例反复呼吸道感染的患儿，平均年龄(8.94±3.65)岁，其中包含男性患儿70例；包含轻症病例98例，重症50例；重症患儿中男童更多，BMI水平更低(P<0.05);重症患儿IgG、IgA、IgM水平均更低(P<0.05);随访发现，重症患儿中复发者比例更高(P<0.05)。重症患儿IgG、IgA、IgM平均水平均低于轻症组，差别均有统计学意义(P<0.05);随访6个月内复发预后评估可见，148例患儿中复发者19例，重症的复发患儿中IgG、IgA、IgM水平显著低于未见复发者(P<0.05)。对潜在影响复发预后的相关因素进行分析，可见性别因素(女性)(OR=1.726)、BMI水平(消瘦)(OR=1.613)、IgG表达水平因素(低表达)(OR=1.898)、IgA表达水平因素(低表达)(OR=3.509)、IgM表达水平因素(低表达)(OR=3.217)以及发病因素(重症)(OR=3.619)为潜在危险因素，会增加不良预后风险。结论 免疫功能低下患儿哮喘发病相对较重，且短期复发可能性更高，值得临床关注并加以预防性干预。更多还原

【Abstract】 Objective To analyze the effect of immune function on the condition and prognosis of asthma in children with asthma. Methods A total of 148 children with asthma diagnosed in Qinghai women and children′s Hospital from January 2018 to January 2021 were included in the analysis, the immune function of the children was determined, and the information of all children was followed up for 6 months after treatment; compared The condition and follow-up prognosis of children with immunocompromised and normal immune function were analyzed and discussed, and the correlation between the expression levels of immunoglobulins(IgG,IgA,IgM) and the condition and short-term recurrence prognosis(6 months) of children was analyzed and discussed, so as to guide Prevention and clinical work.Statistical analysis was done using SPSS19.0. Results The average age of 148 children with recurrent respiratory tract infection in the study was(8.94±3.65) years old, including 70 male children.The condition of the children was evaluated and classified into mild/severe cases: 148 children in this study included mild cases.There were 98 cases and 50 severe cases.There were more males and lower BMI levels in severe children(P<0.05).The levels of IgG,IgA and IgM in children were all lower in severe children(P<0.05).The follow-up found that the proportion of relapses in critically ill children was higher(P<0.05).Comparing the levels of IgG,IgA,and IgM in mild and severe children, the average levels of IgG,IgA,and IgM in severe children were lower than those in the mild group, and the difference was statistically significant(P<0.05);recurrence within 6 months of follow-up Prognostic evaluation showed that 19 of the 148 children had relapse, and the levels of IgG,IgA,and IgM in severe relapsed children were significantly lower than those without relapse(P<0.05).Analysis of the relevant factors potentially affecting the prognosis of recurrence showed that gender(female)(OR=1.726),BMI level(weight loss)(OR=1.613),IgG expression level factor(low expression)(OR=1.898),IgA expression Level factor(low expression)(OR=3.509),IgM expression level factor(low expression)(OR=3.217) and disease factor(severe)(OR=3.619) were potential risk factors, which would increase the risk of poor prognosis. Conclusion The asthma attack in children with immunocompromised immune function is relatively severe, and the short-term recurrence probability is higher, which deserves clinical attention and preventive intervention.更多还原