妊娠合并甲型流行性感冒患者需要住院治疗的影响因素  

Risk factors for hospitalization of pregnant women with influenza A

作　　者：王爱彬 田地 宋美华 张伟 苏芮 钱芳 韩冰 徐艳利 宋蕊 蒋荣猛 陈志海 Wang Aibin;Tian Di;Song Meihua;Zhang Wei;Su Rui;Qian Fang;Han Bing;Xu Yanli;Song Rui;Jiang Rongmeng;Chen Zhihai(Second Department of Infectious Diseases,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院感染二科,100015

出　　处：《中华传染病杂志》2021年第5期281-284,共4页Chinese Journal of Infectious Diseases

基　　金："十三五"国家科技重大专项(2017ZX10305501)。

摘　　要：目的了解妊娠合并甲型流行性感冒(以下简称流感)患者需要住院治疗的影响因素。方法2018年12月至2019年2月于首都医科大学附属北京地坛医院诊治的妊娠合并甲型流感患者261例,收集患者的年龄、妊娠期、合并基础疾病、发病至就诊时间、白细胞计数和淋巴细胞计数等临床资料。比较门诊治疗与住院治疗患者的上述指标。统计学分析采用χ^(2)检验,多因素logistic回归分析妊娠合并甲型流感患者需要住院治疗的影响因素。结果261例妊娠合并甲型流感患者中,住院治疗36例(13.79%),其中10例(27.78%)因严重流感并发症入院,26例(72.22%)因妊娠相关不良事件入院。住院治疗患者年龄≥30岁、妊娠期≥28周、合并基础疾病和淋巴细胞计数<1×10^(9)/L的比例分别为75.00%(27/36)、83.33%(30/36)、16.67%(6/36)和50.00%(18/36),分别高于门诊治疗患者的47.11%(106/225)、35.56%(80/225)、0.89%(2/225)和13.22%(16/121),差异均有统计学意义(χ^(2)=9.66、29.05、26.00、22.12,均P<0.05)。住院治疗患者和门诊治疗患者白细胞计数≥4×10^(9)/L的比例分别为97.22%(35/36)和97.52%(118/121),差异无统计学意义(χ^(2)=0.01,P=0.921)。多因素logistic回归分析显示,年龄≥30岁[比值比(odds ratio,OR)=5.181,95%可信区间(confidence interval,CI)1.628~16.489,P=0.005]、妊娠期≥28周(OR=11.054,95%CI 3.233~37.796,P<0.01)、淋巴细胞计数<1×10^(9)/L(OR=6.864,95%CI 2.237~20.729,P=0.001)、发病至就诊时间<24 h(OR=0.076,95%CI 0.012~0.468,P=0.005)是妊娠合并甲型流感患者需要住院治疗的影响因素。结论年龄≥30岁、妊娠期≥28周、淋巴细胞计数<1×10^(9)/L、发病至就诊时间<24 h是妊娠合并甲型流感患者需要住院治疗的影响因素。Objective To investigate the influencing factors of hospitalization for pregnant women with influenza A.Methods From December 2018 to February 2019,261 pregnant women with influenza A were admitted to Beijing Ditan Hospital,Capital Medical University.The clinical data of age,gestational period,underlying diseases,time from onset to treatment,white blood cell count and lymphocyte count of these patients were collected.Data of out-patients were compared with those of inpatients.Chi-square test and multivariate logistic regression were used to analyze the influencing factors of hospitalization in pregnant women with influenza A.Results Among the 261 cases of pregnancy with influenza A,36 cases(13.79%)were hospitalized,of which 10(27.78%)were hospitalized due to severe influenza complications,the other 26 cases(72.22%)were hospitalized due to pregnancy related adverse events.The proportions of hospitalized patients with age≥30 years old,gestational period≥28 weeks,combined with underlying diseases and lymphocyte count<1×10^(9)/L were 75.00%(27/36),83.33%(30/36),16.67%(6/36)and 50.00%(18/36),respectively,which were significantly higher than those of out-patients(47.11%(106/225),35.56%(80/225),0.89%(2/225)and 13.22%(16/121),respectively;χ^(2)=9.66,29.05,26.00 and 22.12,respectively,all P<0.05).The proportions of inpatients and out-patients with white blood cell count≥4×10^(9)/L were 97.22%(35/36)and 97.52%(118/121),respectively,and there was no significant difference(χ^(2)=0.01,P=0.921).Multivariate logistic regression analysis showed that age≥30 years(odds ratio(OR)=5.181,95%confidence interval(CI)1.628-16.489,P=0.005),gestational period≥28 weeks(OR=11.054,95%CI 3.233-37.796,P<0.01),lymphocyte count<1×10^(9)/L(OR=6.864,95%CI 2.237-20.729,P=0.001),and time from onset to treatment<24 h(OR=0.076,95%CI 0.012-0.468,P=0.005)were the influencing factors for hospitalization of pregnant women with influenza A.Conclusion Age≥30 years old,gestational period≥28 weeks,lymphocyte count<1×10^(9)/L and time from o

关 键 词：流感 人 流感病毒A型 妊娠 住院 

分 类 号：R511.7[医药卫生—内科学]