不同年龄儿童RSV肺炎的临床特征及重症RSV肺炎危险因素分析  

Analysis of clinical characteristics of respiratory syncytial virus pneumonia in children of different ages and risk factors of severe respiratory syncytial virus pneumonia

作　　者：魏金凤 吴素玲 WEI Jinfeng;WU Suling(Department of Respiratory,Hangzhou Children's Hospital,Zhejiang Hangzhou 310014,China)

机构地区：[1]杭州市儿童医院呼吸科,浙江杭州310014

出　　处：《中国妇幼健康研究》2022年第7期24-29,共6页Chinese Journal of Woman and Child Health Research

基　　金：浙江省医药卫生科技计划项目面上项目(2021KY932)。

摘　　要：目的探索不同年龄儿童呼吸道合胞病毒(RSV)肺炎的临床特征及引起重症RSV肺炎的危险因素,为早诊断及防治提供理论和实践依据。方法收集2020年9月至2021年9月在杭州市儿童医院住院的RSV肺炎患儿临床资料,根据年龄分为<2岁组和≥2岁组,比较两组患儿的临床特点,并分析重症RSV肺炎的独立危险因素。结果低龄组患儿(<2岁组)重症、男孩、呼吸道感染接触史、喘息、气促、肺实变、病毒载量>10拷贝/mL、吸氧、使用激素及ALT、CK-MB异常的比例均高于≥2岁组,≥2岁组患儿发热及CRP、PCT异常的比例高于<2岁组,上述差异均有统计学意义(χ^(2)值分别为9.649、7.758、11.908、5.578、8.076、4.501、84.191、6.633、6.655、11.793、7.201、15.712、41.908,P<0.05)。与轻症RSV肺炎相比,重症病例中男孩、年龄12月龄以下、早产和(或)低体重、先天性心脏病、病毒载量>10拷贝/mL、混合感染、喘息、肺实变的比例更高,差异均有统计学意义(χ^(2)值分别为5.132、10.159、40.040、28.942、13.219、4.429、11.042、37.681,P<0.05)。多因素Logistic回归分析显示年龄<12月龄(OR=23.292,95%CI:6.992~77.591)、早产和(或)低体重(OR=4.467,95%CI:1.299~15.360)、喘息(OR=22.911,95%CI:4.729~111.010)、肺实变(OR=9.818,95%CI:1.635~58.942)、病毒载量(OR=3.239,95%CI:1.099~9.551)都是重症RSV肺炎的独立危险因素(P<0.05)。结论不同年龄RSV肺炎患儿的临床特征有一定差异;12月龄以下的婴儿、早产和(或)低体重、喘息、肺实变、病毒载量是RSV重症肺炎的独立危险因素。Objective To explore the clinical features of respiratory syncytial virus(RSV)pneumonia in children of different ages and the risk factors of severe respiratory syncytial virus pneumonia,so as to provide theoretical and practical basis for early diagnosis and treatment.Methods The clinical data of children with RSV pneumonia who were hospitalized in Hangzhou Children′s Hospital from September 2020 to September 2021 were collected.According to age,the children were divided into the<2 years old group and the≥2 years old group.The clinical characteristics of children in the two groups were compared.The independent risk factors of severe RSV pneumonia were analyzed.Results In the younger age group(<2 years old),the proportions of severe respiratory syncytial virus pneumonia,males,contact history of respiratory infection,wheezing,breathlessness,lung consolidation,viral load>10~6 copies/mL,use of oxygen and hormones,and abnormal ALT and CK-MB were higher than those in the≥2 years old group,and the proportions of fever,abnormal CRP and PCT in the≥2 years old group were higher than those of the<2 years old group,and the above differences were statistically significant(χ^(2)=9.649,7.758,11.908,5.578,8.076,4.501,84.191,6.633,6.655,11.793,7.201,15.712 and 41.908,respectively,P<0.05).Compared with the children with mild RSV pneumonia,the proportions of males,aged less than 12 months old,premature birth and(or)low body weight,congenital heart disease,viral load>10~6 copies/mL,mixed infection,wheezing and lung consolidation were higher in children with severe RSV pneumonia,and the differences were statistically significant(χ^(2)=5.132,10.159,40.040,28.942,13.219,4.429,11.042 and 37.681,respectively,P<0.05).Multivariable Logistic regression analysis showed that aged less than 12 months old(OR=23.292,95%CI:6.992-77.591),preterm birth and(or)low body weight(OR=4.467,95%CI:1.299-15.360),wheezing(OR=22.911,95%CI:4.729-111.010),lung consolidation(OR=9.818,95%CI:1.635-58.942),viral load(OR=3.239,95%CI:1.099-9.551)were the i

关 键 词：呼吸道合胞病毒 肺炎 儿童 危险因素 

分 类 号：R179[医药卫生—妇幼卫生保健]