50例儿童重症流感的临床特征和危险因素  

Clinical features and risk factors of severe influenza in 50 children

作　　者：王巧侠[1] 李永勤[1] 刘媛媛 王楠[1] 王小平[2,3] 陈璐 WANG Qiao-xia;LI Yong-qin;LIU Yuan-yuan;WANG Nan;WANG Xiao-ping;CHEN Lu(Department of Infectious Diseases,Xi'an Central Hospital,Xi'an,Shaanxi 710001;Department of Pathology,Shaanxi University of Chinese Medicine,Xianyang,Shaanxi 712046;Department of Medicine,Xizang Minzu University,Xianyang,Shaanxi 712082;Xi'an Medical College,Xi'an,Shaanxi 710021,China)

机构地区：[1]西安市中心医院感染科,陕西西安710001 [2]陕西中医药大学病理学教研室,陕西咸阳712046 [3]西藏民族大学医学部,陕西咸阳712082 [4]西安医学院,陕西西安710021

出　　处：《热带医学杂志》2021年第11期1417-1419,1432,共4页Journal of Tropical Medicine

基　　金：陕西省自然科学基金(2020JM-590);陕西教育厅科研计划重点项目(18JS031);西安市科技局“科技”+行动计划医学研究项目[2019115413YX009SF042(4)]。

摘　　要：目的分析流感患儿重症病例的临床特征及相关危险因素。方法回顾性分析西安市中心医院感染科2018年12月-2019年12月收治的129例14岁以下流感患儿的临床资料,分为重症和普通型两组,对两组临床表现和实验室检查进行比较,采用二元Logistic回归分析重症流感的危险因素。结果重症流感50例(38.76%),普通型流感79例(61.24%)。主要临床表现为发热(76.74%)和咳嗽(79.84%),其次为呕吐(52.71%)。二元Logistic回归分析显示发热持续时间延长(OR=4.28,95%CI:2.48~7.38)、乳酸脱氢酶(LDH)值增高(OR=1.02,95%CI:1.00~1.03)是重症流感的危险因素。发病到服药时间(OR=0.98,95%CI:0.96~1.00)缩短是重症流感的保护因素。结论随着发热持续时间延长、LDH增高,发生重症流感的风险增加。而发病后尽早服用神经氨酸酶抑制剂可减少重症流感发生的风险。Objective To analyze the clinical features and risk factors of severe influenza in children.Methods Clinical data of 129 children with influenza who were hospitalized in Department of Infectious Diseases of Xi’an Central Hospital from December 2018 to December 2019 were analyzed retrospectively.The children were divided into severe group and common group.The clinical manifestations and laboratory examinations were compared.Risk factors for severe influenza were analyzed using binary classification Logistic regression.Results Among the 129 children with influenza,50 cases(38.76%)were severe and 79 cases(61.24%)were common.Fever(76.74%)and cough(79.84%)were the main clinical manifestations,and followed with vomiting(52.71%).Prolonged fever duration(OR=4.28,95%CI:2.48-7.38)and increased lactate dehydrogenase(LDH)(OR=1.02,95%CI:1.00-1.03)were risk factors for severe influenza.Shortening the time from onset to administration(OR=0.98,95%CI:0.96-1.00)was the protective factor of severe influenza.Conclusions With the prolongation of fever duration and the elavation of LDH,the risk of severe influenza increased.Taking neuraminidase inhibitors after onset as early as possible could reduce the risk of severe influenza.

关 键 词：儿童 流行性感冒 重症 临床特征 危险因素 

分 类 号：R725.1[医药卫生—儿科]