儿童腺病毒肺炎的混合感染特点和重症病例的危险因素分析  

Characteristics of mixed infection of adenovirus pneumonia in children and risk factors of severe cases

作　　者：靳丹丹[1] 周卫芳[1] 李嫣[1] 孔小行[1] 田健美[1] JIN Dan-dan;ZHOU Wei-fang;LI Yan;KONG Xiao-xing;TIAN Jian-mei(Children's hospital of Soochow University,Suzhou,Jiangsu,China)

机构地区：[1]苏州大学附属儿童医院

出　　处：《临床肺科杂志》2019年第10期1747-1750,共4页Journal of Clinical Pulmonary Medicine

基　　金：国家自然科学基金资助项目(No 81701948)

摘　　要：目的探讨儿童腺病毒(HADV)肺炎的混合感染特点和重症病例的危险因素。方法选择2015年1月至2017年12月苏州大学附属儿童医院118例儿童HADV肺炎临床资料进行回顾性分析,观察患儿混合感染的特点、重症肺炎的发生率及相关因素。结果118腺病毒肺炎患儿中,6个月~2岁有51例(43.2%),70例(59.3%)合并其他病原感染(支原体45.26%,细菌40.00%),诊断为重症肺炎38例,占32.20%。单因素分析显示,重症肺炎和非重症肺炎组患儿年龄6个月~2岁、发病季节、营养性贫血、反复呼吸道感染、免疫低下等因素相比较存在统计学差异(P<0.05);重症肺炎和非重症肺炎患儿性别、先天性心脏病、支气管哮喘、过敏原、营养不良、手术史、早产、支原体感染、病毒感染、真菌感染和合并感染等因素,不存在统计学差异(P>0.05)。多因素Logistic分析结果显示年龄6个月~2岁、营养性贫血、免疫低下是影响重症肺炎发生的独立风险因素(P<0.05)。结论HADV肺炎混合感染发生率较高,以支原体和细菌感染,重症肺炎转化率较高,对年龄6个月~2岁及合并营养性贫血和免疫低下的患儿应给予重点关注。Objective To investigate the characteristics of mixed infection of adenovirus(HADV)pneumonia in children and the risk factors of severe cases.Methods The clinical data of 118 children with HADV pneumonia in Children s Hospital Affiliated to Soochow University from January 2015 to December 2017 were retrospectively analyzed,and the characteristics of mixed infection in children,the incidence of severe pneumonia and related factors were observed.Results Among 118 children with adenovirus pneumonia,51(43.2%)were 6 months to 2 years old,70(59.3%)were complicated with other pathogenic infections(Mycoplasma 45.26%and Bacteria 40.00%),and 38(32.20%)were diagnosed as severe pneumonia.The univariate analysis showed that there were significant differences between the severe pneumonia group and the non-severe pneumonia group in terms of age 6 months to 2 years,onset season,nutritional anemia,recurrent respiratory infection and immunodeficiency(P<0.05).There was no significant difference in sex,congenital heart disease,bronchial asthma,allergen,malnutrition,surgical history,premature delivery,Mycoplasma infection,viral infection,fungal infection and co-infection between the severe pneumonia group and the non-severe pneumonia group(P>0.05).The multivariate logistic analysis showed that age from 6 months to 2 years,nutritional anemia and immunodeficiency were independent risk factors for severe pneumonia(P<0.05).Conclusion The incidence of mixed infection of HADV pneumonia is higher.Mycoplasma and bacterial infection are relatively common.The independent risk factors for severe cases include age from 6 months to 2 years,nutritional anemia and immunodeficiency.More attention should thus be paid to such cases.

关 键 词：儿童肺炎 腺病毒感染 重症肺炎 危险因素 混合感染 

分 类 号：R725.6[医药卫生—儿科]