影响儿童腺病毒肺炎的严重程度及不良预后的危险因素研究进展  

Progress of risk factors affecting the severity and poor prognosis of adenovirus pneumonia in children

作　　者：沈玥彤(综述) 许巍(审校)[1] Shen Yuetong;Xu Wei(Pediatric Intensive Care Unit of Shengjing Hospital of China Medical University,Shenyang 110004,China;Department of Neonatology,General Hospital of the Northern Theater of the Chinese People′s Liberation Army,Shenyang 110016,China)

机构地区：[1]中国医科大学附属盛京医院小儿重症监护病房,沈阳110004 [2]中国人民解放军北部战区总医院新生儿科,沈阳110016

出　　处：《国际儿科学杂志》2022年第12期819-823,共5页International Journal of Pediatrics

基　　金：国家自然科学基金(81771621);辽宁省重点研发指导计划(2019JH8/10300023)。

摘　　要：早期识别和诊治重症腺病毒肺炎,对降低病死率及减少肺部后遗症的发生至关重要。该文就影响儿童腺病毒肺炎严重程度及不良预后的危险因素研究进展作一综述。7型腺病毒、高腺病毒DNA载量提示急重症及后遗症的发生。影像学上存在胸腔积液及小气道病变的患儿需提高警惕。实验室指标可见细胞因子异常,肺内、肺外各类脏器损害从而导致生化指标的改变均提示重症腺病毒肺炎的发生。年龄小、早产、有基础疾病、发热时间长、喘息、低血红蛋白及白蛋白、混合感染、合并肺外并发症的患儿更易进展为重症腺病毒肺炎。小于2岁、有哮喘家族史、喘息病史,发热时间长、呼吸困难甚至呼吸衰竭,于ICU住院、行呼吸机辅助通气以及全身应用激素的患儿更要警惕肺部后遗症的发生。Early diagnosis and treatment of adenovirus pneumonia is critical to reduce the mortality and pulmonary sequelae.This review summarizes the research progress of risk factors affecting the severity and poor prognosis of adenovirus pneumonia in children.Adenovirus type 7 and high adenovirus DNA load suggest acute severe disease and sequelae.On imaging,children with pleural effusion and small airway lesions need to be vigilant.Abnormal cytokines are observed in laboratory indicators,and changes in biochemical indicators caused by damage of various organs in and outside the lung suggest the occurrence of severe adenovirus pneumonia.Children with young age,premature birth,underlying diseases,long fever,wheezing,low hemoglobin and albumin,mixed infection,and extrapulmonary complications are more likely to progress to severe adenovirus pneumonia.Children younger than 2 years old,with a family history of asthma,history of wheezing,long fever,dyspnea or even respiratory failure,hospitalized in ICU,ventilator-assisted ventilation,and systemic use of hormones should be more vigilant against pulmonary sequelae.

关 键 词：儿童 腺病毒肺炎 危险因素 

分 类 号：R725.6[医药卫生—儿科]