Study on the correlation between the dynamic changes of peripheral blood immune cells and unplanned readmission within 31 d in children with lower respiratory tract infection
Objective To explore the correlation between the dynamic changes of peripheral blood immune cells and unplanned readmission within 31 d in children with lower respiratory tract infection.Methods A total of 1 081 children with lower respiratory tract infection who were hospitalized in the Fourth Affiliated Hospital of Nanjing Medical University from December 2021 to December 2023 were retrospectively selected for the study.According to the unplanned readmission within 31 d after treatment,they were divided into non-readmission group(976 cases)and readmission group(105 cases).The clinical data of the two groups were compared.Repeated measurement analysis of variance was used to analyze the levels of immune cells in the two groups.LOWESS was used to analyze the curve relationship between the level of immune cells and expiratory flow when 25％tidal volume(TEF25).Multivariate Logistic regression was used to analyze the risk factors of unplanned readmission within 31 d,and the model was evaluated.Restricted cubic spline method was used to analyze the relationship between immune cell levels and the risk of unplanned readmission within 31 d.Results Compared to the non-readmission group,the TEF25 levels were significantly lower in the readmission group[(61±9)ml/s vs(70±9)ml/s],and the passive smoking,outdoor activity time＜2 h/d,annual use of antibiotics≥3 times/year,and C-reactive protein(CRP)levels were significantly higher(all P＜0.05).There were significant differences in the levels of immune cells between the two groups in terms of time effect,between-group effect and interaction effect(all P＜0.05).LOWESS analysis showed that there was a non-sexualrelationship between the level of immune cells and TEF25.Multivariate Logistic regression analysis showed that passive smoking,outdoor activity time＜2 h/d,annual use of antibiotics ≥3 times/year,TEF25,CRP levels,levels of CD3+,CD4+,CD8+,CD4+/CD8+T cells ratio before treatment were independent risk factors for unplanned readmission within 31 d of lower respiratory tract infection in children(all P＜0.05).The data points in the modeling data did not have a strong influence on the model parameter estimation.There was no multicollinearity among variables.The model has high discrimination ability,prediction ability and validity.The results of restricted cubic spline analysis showed that there was a negative linear relationship between the risk of unplanned readmission within 31 d and the levels of CD3+,CD4+,and CD4+/CD8+T cells ratio before treatment,and a positive linear relationship between the risk of unplanned readmission and CD8+T cells level in children with lower respiratory tract infection.Conclusion There is a significant correlation between the dynamic changes of peripheral blood immune cells and the unplanned readmission of children with lower respiratory tract infection within 31 d.Clinically,monitoring the changes in peripheral blood immune cell levels can help take preventive measures in time to reduce the incidence of unplanned readmission.
Lower respiratory tract infectionPeripheral blood immune cellsUnplanned readmission within 31 d
万方数据
维普
