重症小儿腺病毒肺炎临床特征及危险因素调查分析  

Investigation of the clinical characteristics of adenovirus pneumonia in children and Logistic regression analysis of risk factors

作　　者：陈爱萍 肖志刚 肖宗浩 邹婕 CHEN Ai-ping;XIAO Zhi-gang;XIAO Zong-hao;ZOU Jie(Department of Pediatrics,Meizhou Women and Children’s Hospital,Meizhou 514000,China)

机构地区：[1]梅州市妇女儿童医院儿科,广东梅州514000

出　　处：《社区医学杂志》2021年第18期1096-1100,共5页Journal Of Community Medicine

基　　金：2018年度梅州市社会发展科技计划(181227122051313)。

摘　　要：目的调查小儿腺病毒肺炎的临床特征,分析重症腺病毒肺炎的危险因素,为小儿腺病毒肺炎的防控提供参考。方法选取2018-11-01-2019-12-31梅州市妇女儿童医院收治的182例小儿腺病毒肺炎住院患儿为调查对象。根据病情程度分为轻症腺病毒肺炎139例(对照组)和重症腺病毒肺炎43例(病例组)。收集患儿临床特征资料,采用Logistic回归分析筛选出重症腺病毒肺炎的危险因素。结果轻症、重症腺病毒肺炎患儿的性别(χ^(2)=0.195,P=0.659)、年龄(χ^(2)=12.186,P=0.058)、季节分布(χ^(2)=0.930,P=0.335)以及合并支气管哮喘(χ^(2)=2.058,P=0.151)比较,差异无统计学意义;重症腺病毒肺炎患儿中高热(χ^(2)=20.413,P<0.001)、发热天数≥7d(χ^(2)=4.427,P=0.035)、早产史(χ^(2)=6.726,P=0.009)、合并先天性气道发育异常(χ^(2)=17.299,P<0.001)、合并先天性心脏病(χ^(2)=12.874,P<0.001)、合并营养不良(χ^(2)=6.042,P=0.014)、反复呼吸道感染(χ^(2)=10.892,P=0.001)、合并缺铁性贫血(χ^(2)=13.766,P<0.001)、既往手术史(χ^(2)=17.375,P<0.001)、合并其他病原体感染者(χ^(2)=12.581,P=0.006)均高于轻症腺病毒肺炎。Logistic回归分析结果显示,合并先天性心脏病(OR=3.219,P<0.001)、合并营养不良(OR=2.560,P=0.010)、合并缺铁性贫血(OR=2.052,P=0.002)、既往手术史(OR=2.875,P=0.014)、合并细菌感染(OR=3.108,P=0.002)是发生重症腺病毒肺炎的独立危险因素。结论自身基础疾病是小儿腺病毒肺炎进展为重症肺炎的危险因素,临床应加强自身基础疾病的治疗,增强儿童营养和机体免疫力,以期改善预后。Objective To investigate the clinical characteristics of adenovirus pneumonia in children,and analyze the risk factors for severe adenovirus pneumonia,so as to provide reference for prevention and control of adenovirus pneumonia in children.Methods 182 children who were hospitalized in Meizhou Women and Children’s Hospital from November 1,2018 to December 31,2019 due to adenovirus pneumonia were enrolled in this retrospective study.According to the severity of the disease,the children were divided into control group(139 cases with mild adenovirus pneumonia)and case group(43 cases with severe adenovirus pneumonia).Data on the clinical characteristics of children were collected,and Logistic regression analysis was performed to screen risk factors of severe adenovirus pneumonia.Results There were no significant differences in gender(χ^(2)=0.195,P=0.659),age(χ^(2)=12.186,P=0.058),seasonal distribution(χ^(2)=0.930,P=0.335)and the proportion of cases with bronchial asthma(χ^(2)=2.058,P=0.151)between children with mild and severe adenovirus pneumonia.The proportions of children with high fever(χ^(2)=20.413,P<0.001),duration of fever≥7 days(χ^(2)=4.427,P=0.035),history of premature birth(χ^(2)=6.726,P=0.009),congenital airway dysplasia(χ^(2)=17.299,P<0.001),congenital heart disease(χ^(2)=12.874,P<0.001),malnutrition(χ^(2)=6.042,P=0.014),recurrent respiratory tract infection(χ^(2)=10.892,P=0.001),iron-deficiency anemia(χ^(2)=13.766,P<0.001),previous surgical history(χ^(2)=17.375,P<0.001)and other pathogen infections(χ^(2)=12.581,P=0.006)were higher in children with severe adenovirus pneumonia than those with mild adenovirus pneumonia.Logistic regression analysis showed that congenital heart disease(OR=3.219,P<0.001),malnutrition(OR=2.560,P=0.010),iron-deficiency anemia(OR=2.052,P=0.002),previous surgical history(OR=2.875,P=0.014)and bacterial infection(OR=3.108,P=0.002)were independent risk factors for severe adenovirus pneumonia.Conclusions Own underlying diseases were risk factors for severe adenovirus

关 键 词：腺病毒 腺病毒肺炎 重症肺炎 危险因素 

分 类 号：R563.1[医药卫生—呼吸系统]