原発性免疫不全症患者および再発性呼吸器感染症の小児群の体重と身長の評価

Assessment of weight and height of patients with primary immunodeficiency disorders and group of children with recurrent respiratory tract infections.

• Karolina Pieniawska-Śmiech
• Kamil Bar
• Mateusz Babicki
• Karol Śmiech
• Aleksandra Lewandowicz-Uszyńska

抄録

背景:

原発性免疫不全症（PID）は、免疫応答が不十分な慢性的な重篤な疾患群です。その結果、感染症にかかりやすくなります。現在までに、このグループに分類される疾患は約350種類あります。また、再発性呼吸器感染症（RRTI）の患者さんもいますが、このグループでは免疫学的検査を行っても異常は見られません。子どもの身体の発育には、医学的なことも含めて多くの要因が影響します。出生時の体重や体長、体重、身長、入院時のBMIなどのデータは、ヴロツワフ市のJ.グロムコフスキ病院の臨床免疫学・小児科病棟に入院していた195人の患者の病歴から収集された。調査対象はPIDs、RRTI患者と健常児の対照群であった。私たちの目的は、PID患者とRRTI患者の身長と体重の評価により、身体的成長を評価することであった。すべてのパラメータはポーランドの人口に最も適したセンタイル図を用いて評価した。

BACKGROUND: Primary immunodeficiences (PIDs) are a group of chronic, serious disorders in which the immune response is insufficient. In consequence, it leads to an increased susceptibility to infections. Up to date, there are about 350 different disorders classified in that group. There are also patients suffering from recurrent respiratory tract infections (RRTI), however that group doesn't present any abnormalities in terms of conducted immunological tests. Many factors, including medical, can have an impact on physical development of a child. Data such as birth weight and length, also weight, height, BMI during admission to the hospital were collected from 195 patients' medical histories from their hospitalization at Clinical Immunology and Paediatrics Ward of J. Gromkowski Hospital in Wrocław. Investigated groups included patients with PIDs, RRTI and a control group of healthy children. Our purpose was to evaluate the physical growth of children with PID and children with RRTI by assessment of their height and weight. All of parameters were evaluated using centile charts, suitable best for the Polish population.

結果:

出生時の平均体重と身長が最も低いのはPID患者群であった。入院中にPIDを発症した子供の平均体重は対照群に比べて統計的に低く、身長はほぼ18％が3パーセンタイル以下であった。体重、身長、栄養状態の点でRRTI群との間に統計学的に有意な差が認められた。PID群と対照群の栄養状態の間に統計的に有意な差が検出されました。

RESULTS: The lowest mean birth weight and height was found among the PIDs patients group. Children with PIDs during hospitalization had statistically relevant lower mean weight than the control group and almost 18% of them had their height situated below 3rd percentile. The statistically relevant differences have been found between them and RRTI group in terms of weight, height and nutritional status. The statistically significant difference was detected between the nutritional status of PID and control group.

結論:

PID患者の身体的成長異常の割合は健常児に比べて高い。我々の知見は、免疫システムの異常と子供の身体的成長への影響についての更なる調査の必要性を示しています。

CONCLUSIONS: There is a higher percentage of PID patients with physical growth abnormalities in comparison to healthy children. Our findings indicate a need for further investigation of immune system irregularities and their influence on physical growth of children.