2015年-2018年住院患儿腺病毒和合胞病毒肺炎的临床特征分析  

Clinical Characteristics of Adenovirus and Syncytial Virus Pneumonia in Hospitalized Children from 2015 to 2018

作　　者：李攀[1] 郎艳美 石艳玺 Li Pan;Lang yanmei;Shi yanxi(Children’s Hospital of Hebei Province,Shijiazhuang 050031,Hebei Province,China)

机构地区：[1]河北省儿童医院

出　　处：《中国病案》2019年第11期93-96,共4页Chinese Medical Record

基　　金：河北省卫生科教青年科技课题(20180617)

摘　　要：目的探讨腺病毒和合胞病毒肺炎患儿发病及临床特征,为早期诊断和临床治疗提供依据。方法选取2015年1月-2018年12月期间收治的ADV和RSV导致的肺炎患儿作为研究对象,根据感染的病毒类型分为腺病毒肺炎组60例和合胞病毒肺炎组67例。通过病例报告和医疗文书,分析比较2组肺炎患儿的季节分布、年龄分布、临床特征、实验室检查和并发症。结果ADV组和RSV组患儿肺炎患病的季节分布情况和年龄分布情况相似,2组肺炎在春季和冬季的发病比例都高于夏季和秋季,且2组肺炎的发病主要分布在6个月~2岁,差异均无统计学意义(P>0.05)。与ADV组肺炎患儿比较,RSV组肺炎患儿体温>39.7℃、双肺闻及喘鸣音和肺炎高危因素的症状明显,差异具有统计学意义(P<0.05);气促、痰壅和严重咳嗽的症状与ADV组相比,差异无统计学意义(P>0.05)。2组肺炎患儿都存在C反应蛋白升高、白细胞升高、心肌损害、肝脏损害和血沉增快的表现,差异无统计学意义(P>0.05)。2组肺炎患儿都可见免疫低下、哮喘、呼吸衰竭、急性呼吸窘迫综合征、消化道出血、胸腔积液和肾功能异常等并发症。与ADV组肺炎患儿相比,RSV组肺炎患儿并发症多见细支气管炎和鼻炎、咽炎、喉炎,少见中毒性心肌炎、肝功能异常、中毒性肝炎、电解质紊乱、症状性腹泻和中毒性脑病(P<0.05)。结论临床上需要考虑腺病毒和合胞病毒感染的肺炎患儿的症状,在春冬2季需要对6个月~2岁的儿童做好预防措施,有高热、双肺闻及喘鸣音、肺炎高危因素或合并细支气管炎和鼻炎、咽炎、喉炎的患儿多考虑RSV肺炎,而合并中毒性心肌炎、肝功能异常、中毒性肝炎、电解质紊乱、症状性腹泻和中毒性脑病的患儿多考虑ADV肺炎。针对这2种肺炎不同的临床症状和并发症要对症下药,以提高治疗效果。Objectives To explore the differences of the onset season and age distribution,clinical features,laboratory examination results and other relevant indicators in children with adenovirus and syncytial virus pneumonia,so as to provide basis for early diagnosis and clinical treatment.Methods Children with pneumonia caused by ADV and RSV between January 2015 and December 2018 were selected as the research objects,and divided into 60 cases of adenovirus virus(ADV group)and 67 cases of Respiratory syncytial virus(RSV group)according to the type of infection.The seasonal distribution,age distribution,clinical characteristics,laboratory examinations and complications in the two groups were analyzed and compared through case reports and medical documents.Results The seasonal distribution and age distribution of pneumonia were similar in the ADV group and RSV group,the incidence rate of pneumonia in spring and winter was higher than that in summer and autumn,and the incidence of pneumonia in the two groups was mainly between 6 months and 2 years old,with no statistical significance(P>0.05).Compared with ADV group of pneumonia in children,children with RSV pneumonia group temperature>39.7℃,double lung smell and risk factors of wheezing and pneumonia symptoms,statistically significant difference(P<0.05).Two groups of children with pneumonia were elevated c-reactive protein,interleukin increased,myocardial damage,liver damage and blood sedimentation faster performance,there was no statistically significant difference(P>0.05).Complications such as immunodeficiency,asthma,respiratory failure,acute respiratory distress syndrome,gastrointestinal bleeding,pleural effusion,and renal dysfunction were found in both groups.The complications of pneumonia in RSV group were more likely to be bronchiolitis,rhinitis,pharyngitis and laryngitis,and less likely to be toxic myocarditis,liver dysfunction,toxic hepatitis,electrolyte disorder,symptomatic diarrhea and toxic encephalopathy(P<0.05).Conclusions Symptoms of pneumonia in children inf

关 键 词：肺炎 腺病毒 合胞病毒 临床特征 

分 类 号：R725.6[医药卫生—儿科]