2018-2020年某院PICU甲型流感病毒性肺炎临床和流行病学特征  

Clinical and epidemiological characteristics of influenza A virus-induced pneumonia in PICU of a hospital from 2018 to 2020

作　　者：周明杨 孙莹[1] 颜景礼 贺琳晰[1] 富园园 ZHOU Ming-yang;SUN Ying;YAN Jing-li;HE Lin-xi;FU Yuan-yuan(Shengjing Hospital,China Medical University,Shenyang,Liaoning 110000,China)

机构地区：[1]中国医科大学附属盛京医院第一小儿重症监护病房,辽宁沈阳110000

出　　处：《中华医院感染学杂志》2022年第2期168-172,共5页Chinese Journal of Nosocomiology

基　　金：辽宁省科研基金资助项目(201921411)。

摘　　要：目的分析某院2018-2020年儿科监护病房(PICU)甲型流感病毒性肺炎患儿流行病学特点。方法选取2018年5月-2020年4月中国医科大学附属盛京医院PICU收治的70例甲型流感病毒性肺炎患儿为研究对象,分析患儿的流行病学特点、临床表现、实验室指标及影像学特点。结果甲型流感病毒肺炎呈季节性流行,冬春季为发病高峰,患儿平均年龄(2.03±0.24)岁。37例占52.86%合并基础疾病,检出合并细菌感染、其他病毒感染、肺炎支原体感染分别为36例占51.43%、15例占21.43%、9例占12.86%。重症甲型流感病毒肺炎组年龄≤3岁、肥胖、合并神经系统疾病、先心病、营养不良、气道发育异常、混合感染比例高于轻症组(P<0.05),呼吸困难、气促、喘息、细湿啰音、急性呼吸窘迫综合征(ARDS)、惊厥发生率高于轻症组(P<0.05)。重症组患儿大部分实验室检测指标水平高于轻症组(P<0.05),影像学特点中肺实变比例高于轻症组(P<0.05)。结论2018-2020年医院PICU甲型流感病毒性肺炎患儿呈季节性流行,年龄、肥胖、合并先心病、营养不良、发生混合感染、实验室指标水平较高、影像学表现肺实变易发展为重症甲型流感病毒肺炎。OBJECTIVE To investigate the epidemiological characteristics of influenza A virus-induced pneumonia in children of pediatric intensive care unit(PICU)of a hospital from 2018 to 2020.METHODS A total of 70 children with influenza A virus pneumonia who were treated in PICU of Shengjing Hospital,China Medical University from May 2018 to Apr 2020 were recruited as the study subjects.The epidemiological characteristics,clinical manifestations,laboratory test indexes and imaging characteristics were observed.RESULTS The influenza A virus pneumonia showed seasonal epidemic and was at peak in winter and spring.The average age of the children was(2.03±0.24)years old.37(52.86%)children were complicated with underlying diseases,36(51.43%)children were complicated with bacterial infection,15(21.43%)were complicated with infections of other viruses,and 9(12.86%)were complicated with Mycoplasma pneumoniae infection.The proportions of the children with no more than 3 years old,obesity,nervous system diseases,congenital heart disease,malnutrition,airway dysplasia and mixed infections were significantly higher in the severe influenza A virus pneumonia group than in the mild group(P<0.05).The incidence rates of dyspnea,shortness of breath,wheezing,fine moist rales,acute respiratory distress syndrome(ARDS)and convulsions were significantly higher in the severe group than in the mild group(P<0.05).The levels of most of laboratory test indexes were significantly higher in the severe group than in the mild group(P<0.05).The imaging result showed that the proportion of the children with pulmonary consolidation was significantly higher in the severe group than in the mild(P<0.05).CONCLUSION The influenza A virus pneumonia shows seasonal epidemic in PICU of the hospital from 2018 to 2020,and the children with younger age,obesity,congenital heart disease,malnutrition,mixed infection,high levels of laboratory test indexes and pulmonary consolidation are prone to develop into severe influenza A virus pneumonia.

关 键 词：儿科监护病房 甲型流感病毒性肺炎 流行病学特点 重症 

分 类 号：R563.1[医药卫生—呼吸系统]