2-60月龄儿童社区获得性肺炎伴低钠血症的临床特征、严重程度与预后的关系

Mymensingh medical journal : MMJ Pub Date : 2023-07-01
M R Sarker, M A Ali, A K Roy, A Yesmin, S K Dhar, E Ahmed, F Ahmed, S E Amin
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引用次数: 0

摘要

低钠血症是临床实践中最常见的电解质失衡,也是社区获得性肺炎儿童常见的实验室检查结果。本研究旨在探讨2-60月龄儿童社区获得性肺炎伴低钠血症的临床特征、严重程度与预后的关系。本描述性横断面研究在孟加拉国Mymensingh医学院附属医院儿科完成。研究时间为2016年11月至2017年4月,为期6个月。数据从符合选择标准的2个月至60个月大的儿童中收集。在这项研究中,抽样技术是有目的的。详细记录病史,并进行了细致的检查和相关调查。纳入100例社区获得性肺炎患者,34.0%的患者存在低钠血症,66.0%的患者无低钠血症。低钠血症在严重肺炎中更为明显(45.5%),其次是中度肺炎(33.3%),而在轻度肺炎中未发现低钠血症。肺炎伴低钠血症患者的平均体温、呼吸频率、心率、点头、鼻炎、咕噜声、喘鸣、发绀、惊厥、进食问题、进气性差明显高于无低钠血症的肺炎患者。肺炎合并低钠血症患者的平均症状持续时间和平均住院时间也明显高于低钠血症患者。低钠血症患者平均血清钠浓度为132.18±1.51mmol/L,正常血症患者平均血清钠浓度为137.91±1.94mmol/L。肺炎合并低钠血症患者白细胞总数、血沉和c反应蛋白的平均值均显著升高。低钠血症患者血清血红蛋白明显低于正常钠血症患者。社区获得性肺炎(CAP)合并低钠血症患者中,斑片状混浊占55.9%,实变占26.5%,间质混浊占11.8%,肺膨出占5.9%。所有患者均给予适当的抗生素和液体治疗,完全康复后出院,无并发症。研究人群中没有死亡病例。从本研究我们可以得出结论,低钠血症与社区获得性肺炎(CAP)的严重程度直接相关。临床表现和调查结果的强度也与肺炎的严重程度直接相关。
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Relationship between Clinical Profile, Severity and Outcome of Community Acquired Pneumonia with Hyponatremia in Children Aged 2-60 Months.

Hyponatremia is the most common electrolyte imbalance seen in clinical practice and a common laboratory findings in children with community acquired pneumonia. This study aimed to find out relationship between clinical profile, severity and outcome of community acquired pneumonia with hyponatremia in children aged 2-60 months. This descriptive cross-sectional study was done in pediatrics department of Mymensingh Medical College Hospital, Bangladesh. Study period was 6 month from November 2016 to April 2017. Data were collected from 2 months to 60 months old children who fulfill the selection criteria. In this study sampling technique was purposive. Detailed history was taken, and meticulous examinations and relevant investigations were performed. 100 patients with community acquired pneumonia were enrolled, 34.0% patient had hyponatremia and 66.0% patients had no hyponatremia. Hyponatremia is more marked (45.5%) in severe pneumonia followed by moderate pneumonia (33.3%) and no hyponatremia found in mild pneumonia. Mean temperature, respiratory rate, heart rate, head nodding, nasal flaring, grunting, stridor, cyanosis, convulsion, feeding problem, Poor air entry were significantly higher in patient of pneumonia with hyponatremia when compared to patient of pneumonia without hyponatremia. Mean duration of symptoms and mean duration of hospital stay were also significantly higher in patient of pneumonia with hyponatremia. The mean serum sodium concentration was 132.18±1.51mmol/L in hyponatremic patients and 137.91±1.94mmol/L in normonatremic patients. Mean values of total leucocyte count, ESR, and C-reactive protein were significantly higher in patient of pneumonia with hyponatremia. Serum hemoglobin was significantly lower in hyponatremic patients than normonatremic patients. Maximum (55.9%) patients of community acquired pneumonia (CAP) with hyponatremia had patchy opacity, 26.5% had consolidation, 11.8% had interstitial opacity and 5.9% had pneumatocele. All the patients were treated with appropriate antibiotics and fluid and discharged after complete recovery without any complication. There was no death in the study population. From this study we can conclude that, hyponatremia is directly related with the severity of community acquired pneumonia (CAP). The intensity of clinical profile and investigation findings are also directly related with the severity of pneumonia.

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Relationship between Clinical Profile, Severity and Outcome of Community Acquired Pneumonia with Hyponatremia in Children Aged 2-60 Months. Status of Serum Calcium and Magnesium in Hospital Admitted Chronic Kidney Disease Patients in Mymensingh Locality of Bangladesh. Relation of Neutrophil-Lymphocyte Ratio with Clinical Severity in Patients with Guillain-Barre Syndrome. Species Identification and Antifungal Susceptibility Pattern of Candida Isolates in Patients with Vulvovaginitis from Mymensingh, Bangladesh. Antibacterial Effects of Chloroform Henna (Lawsonia inermis) Leaf Extracts against Two Nosocomial Infection Causing Pathogens: Gram-positive Staphylococcus aureus and Gram-negative Klebsiella pneumoniae: A Comparative Study.
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