呼吸道合胞病毒感染致支气管肺炎患儿继发血小板增多症的临床特征及意义  

The clinical features and significance of secondary thrombocytosis in children with bronchopneumonia caused by respiratory syncytial virus infection

作　　者：李伟 刘琳研 李娇 陈旺旺 段晴蓂薆 万晓嘉 甘德建 王明亚 周霞 闫军 LI Wei;LIU Linyan;LI Jiao;CHEN Wangwang;DUAN Qinming′ai;WAN Xiaojia;GAN Dejian;WANG Mingya;ZHOU Xia;YAN Jun(Department of Pediatrics,Chongqing Jiulongpo Distric People′s Hosptial,Chongqing,400050,China)

机构地区：[1]重庆市九龙坡区人民医院儿科,400050

出　　处：《重庆医学》2020年第19期3216-3219,共4页Chongqing medicine

基　　金：重庆市区域医学重点学科建设项目(渝卫办科教发[2016]190号)。

摘　　要：目的探讨呼吸道合胞病毒(RSV)感染致支气管肺炎患儿继发性血小板增多症(ST)的临床特征及意义。方法回顾性分析该院2017年2月至2019年3月儿科确诊的支气管肺炎RSV阳性168例,RSV感染患儿中继发血小板增多与血小板正常者的临床资料。结果RSV感染肺炎患儿中ST组76例,其中男34例、女42例,年龄5~27个月,中位年龄6个月;血小板正常组92例,男45例、女47例,年龄4~26个月,中位年龄5个月。与血小板正常组比较,ST组的住院时间、吼喘持续时间更长,白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)、血清淀粉样蛋白A(SAA)水平更高,需吸氧率、肺外并发症及合并多种病原感染发生率均更高,差异均有统计学意义(P<0.05)。血小板计数与住院时间、喘息持续时间、WBC、CRP、PCT、SAA呈显著正相关(r=0.212~0.544,P<0.05)。结论支气管肺炎RSV感染所致的ST患儿可表现出更严重的临床症状、实验室检查及肺外并发症,需引起临床工作者的重视。Objective To explore the clinical features and significance of secondary thrombocytosis(ST)in children with bronchopneumonia caused by respiratory syncytial virus(RSV)infection.Methods To retrospectively analyze the clinical data of 168 children with RSV-positive bronchopneumonia diagnosed in the pediatric department from February 2017 to March 2019 in the hospital,and the clinical data of patients with RSV infection with thrombocytosis and normal platelets.Results Among children with RSV-infected pneumonia,76 cases were in the ST group,including 34 males and 42 females,aged 5-27 months,with a median age of 6 months;92 cases in the normal platelet group,45 males and 47 females,aged 4-26 months,with a median age of 5 months.Compared with the normal platelet group,the ST group had longer hospital stay,longer duration of wheezing;white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),serum amyloid A(SAA)levels,the rate of oxygen demand,extrapulmonary complications and multiple pathogenic infections were all higher,and the differences were statistically significant(P<0.05).Platelet count was significantly positively correlated with hospital stay,duration of wheezing,WBC,CRP,PCT,SAA(r=0.212-0.544,P<0.05).Conclusion More severe clinical manifestations and higher complication morbidity could be observed in the group of RSV combined with secondary thrombocytosis,need to attract the attention of clinicians.

关 键 词：支气管肺炎 呼吸道合胞病毒 继发性血小板增多症 临床特征 

分 类 号：R725.6[医药卫生—儿科]