上海交通大学学报（医学版）

上海交通大学学报(医学版) ›› 2020, Vol. 40 ›› Issue (07): 923-928.doi: 10.3969/j.issn.1674-8115.2020.07.010

• 论著·临床研究 • 上一篇    下一篇

城市1岁以下婴儿急性中耳炎临床特点与危险因素分析

倪 坤1，赵利敏1，李晓艳1，时海波2   

  1. 1. 上海市儿童医院/上海交通大学附属儿童医院耳鼻咽喉头颈外科，上海200062; 2. 上海交通大学附属第六人民医院耳鼻咽喉头颈外科，上海交通大学耳鼻咽喉科研究所，上海 200233
  • 出版日期:2020-07-28 发布日期:2020-09-23
  • 通讯作者: 时海波，电子信箱：hbshi@sjtu.edu.cn。
  • 作者简介:倪 坤（1981—），女，主治医师，博士生；电子信箱：nikun1008@163.com。
  • 基金资助:
    上海市教育委员会高峰高原学科建设计划（20152233）；上海领军人才计划（2017062）。

Clinical characteristics and risk factors of acute otitis media in infants under one-year-old

NI Kun1, ZHAO Li-min1, LI Xiao-yan1, SHI Hai-bo2   

  1. 1. Department of Otolaryngology-Head & Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, China; 2. Department of Otolaryngology-Head & Neck Surgery, Shanghai Sixth People's Hospital, Otolaryngology Institute, Shanghai Jiao Tong University, Shanghai 200233, China
  • Online:2020-07-28 Published:2020-09-23
  • Supported by:
    Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support (20152233); Leading Talents in Shanghai (2017062).

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摘要： 目的·了解城市1岁以下婴儿急性中耳炎（acute otitis media, AOM）的症状和体征特点，并分析其发病危险因素。方法·选取2018年1月—12月在上海市儿童医院检查的足月产、听力筛查正常的婴儿共304名，随访至1周岁，收集其保育信息以及发生AOM婴儿的临床特征。采用χ2检验分析AOM组和对照组（未发生AOM）婴儿在喂养情况、日常照顾、外出情况、居住环境和是否接种肺炎球菌疫苗等因素上的差异，并用Logistic回归模型探讨1岁以下婴儿AOM发病的危险因素。结果·共有177名（58.2%）婴儿发生AOM，平均发病月龄为（5.65±2.03）个月；127名（41.8%）婴儿未发生AOM。与对照组相比，AOM组婴儿吐奶（P=0.000）、经常挖耳（P=0.021）、参加早教活动（P=0.000）、发生反复呼吸道感染（P=0.000）的比例较高，接种肺炎球菌疫苗的比例较低（P=0.000）。Logistic回归分析结果显示，吐奶（OR=2.774，P=0.002）、参加早教活动（OR=3.785，P=0.000）、反复呼吸道感染（OR=3.638，P=0.000）是婴儿AOM发病的危险因素，接种肺炎球菌疫苗是婴儿AOM发病的保护因素（OR=0.320，P=0.000）。结论·AOM是上海地区1岁以下婴儿的高发疾病。坚持科学喂食体位、减少吐奶、注意参加早教等公共场所活动时的额外防护可能减少婴儿AOM的发生，接种肺炎球菌疫苗可能有助于预防AOM。

关键词: 婴儿, 急性中耳炎, 危险因素, 保育, 公共场所

Abstract:

Objective · To analyze the symptoms and signs of acute otitis media (AOM) in infants under one-year-old and the risk factors of AOM. Methods · Care information and clinical characteristics of a total of 304 full-term delivery infants with normal hearing who were examined in Shanghai Children's Hospital from January to December 2018 were included in the analysis. All infants were followed up to one-year-old and the clinical characteristics of AOM infants were collected. χ2 test was used to analyze whether there was a statistically significant difference between the AOM group (AOM infants) and the control group (infants without AOM) in terms of feeding status, daily care, going out, living environment, pneumococcal vaccination, and so on. Logistic regression model was used to explore the risk factors for AOM in infants under one-year-old. Results · In 304 infants, 177 developed AOM, and the age of AOM infants was (5.65±2.03) months. Compared with the control group, AOM group had higher rates of spitting up milk (P=0.000), frequent ears digging (P=0.021), participation in early education activities (P=0.000) and recurrent respiratory infection (P=0.000), and lower rate of pneumococcal vaccination (P=0.000). Logistic regression analysis showed that vomiting (OR=2.774, P=0.002), participation in early education activities (OR=3.785, P=0.000) and recurrent respiratory infection (OR=3.638, P=0.000) were risk factors for AOM in infants, and pneumococcal vaccination was a protective factor (OR=0.320, P=0.000). Conclusion · AOM is a high-incidence disease in infants under one-year-old in Shanghai. Insisting on scientific feeding position, reducing spitting and paying attention to the extra protection when participating in public activities such as early education may reduce the occurrence of AOM. Pneumococcal vaccination may help prevent AOM.

Key words: infant, acute otitis media (AOM), risk factor, conservation, public place

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