苏州地区377例流感相关肺炎住院患儿临床特征分析  

Analysis of Clinical Characteristics of 377 Hospitalized Children with Influenza-Related Pneumonia in Suzhou

作　　者：葛奕苇 成芳芳[1] 惠兆芳 李晓红 马玉兰 于秋瑶 周玉林[1] GE Yi-wei;CHENG Fang-fang;HUI Zhao-fang;LI Xiao-hong;MA Yu-lan;YU Qiu-yao;ZHOU Yu-lin(Department of Infectious Diseases,Children's Hospital of Soochow University,Suzhou,Jiangsu,215003,China)

机构地区：[1]苏州大学附属儿童医院感染性疾病科,江苏苏州215003

出　　处：《中国血液流变学杂志》2022年第4期613-617,共5页Chinese Journal of Hemorheology

基　　金：苏州市儿童感染性疾病精准诊治重点实验室(SZS2020310)。

摘　　要：目的研究苏州地区儿童流感相关肺炎的临床特征,并分析混合感染的发生情况以指导治疗。方法收集2019年11月—2020年1月苏州大学附属儿童医院收治的377例流感病毒相关肺炎患者的临床资料,对其临床症状、实验室检查、混合感染病原学、治疗方法进行回顾性分析。结果共收治流感相关肺炎患儿377例,其中男220例,女157例,年龄分布1个月~12岁7个月,幼儿组(1~3岁)分布最多,有129例,占34.2%,其次为学龄前组(3~6岁)123例,占32.6%。90.9%的患儿表现有发热,其中高热患儿223例,占59.2%。头痛、乏力、肌肉酸痛等全身症状更多见于学龄前组和学龄组。部分患儿出现呕吐及腹泻表现,分别为12.3%和9.5%。实验室检查中,婴儿组最常见白细胞降低,占72.1%,与其他3组比较,差异有统计学意义(P<0.001),其他3组更多表现为白细胞正常。CRP正常患儿282例,占74.8%。丙氨酸氨基转移酶增高42例,肌酸激酶同工酶增高56例,婴儿组肝功能异常及心肌损害发生率最高,与幼儿组及学龄前组相比,差异具有统计学意义(P<0.05)。254例(67.4%)患儿为流感病毒混合其他病原体感染,细菌和支原体检出率较高,分别为146例(38.7%)和131例(34.7%),合并其他病毒感染者有42例(11.1%),其中,学龄前组混合支原体感染的发生率显著高于其他3组,差异有统计学意义(P<0.001)。入组患儿大多预后良好,平均住院时间7.7 d,其中有340例使用抗生素治疗。结论流感相关肺炎高热发生率高,大龄组患儿更容易有全身症状,部分患儿可合并有消化道表现。婴儿组多白细胞减低,其他年龄组患儿大多白细胞正常,CRP各年龄组患儿多表现为正常,脏器损害更多发生在婴儿组。儿童流感相关肺炎混合感染发生率高,以混合细菌感染发生率最高,但学龄期儿童混合肺炎支原体感染更多见。需结合患儿年龄及临床表现合理选用抗生素。Objective To study the clinical characteristics of influenza-related pneumonia and the occurrence of mixed infections in children in Suzhou to guide treatment.Methods Clinical data of 377 patients with influenza virus-related pneumonia admitted to the Children's Hospital of Soochow University from November 2019 to January 2020 were collected,and their clinical symptoms,laboratory tests,mixed infection etiology,and treatment methods were retrospectively analyzed.Results A total of 377 children with influenza-related pneumonia were admitted,including 220 males and 157 females,aged from 1 month to 12 years and 7 months.The infant group(1-3 years old)had the largest distribution,with 129 cases,accounting for 34.2%,followed by the preschool group(3-6 years old)with 123 cases,accounting for 32.6%.90.9%of children had fever,223 children with high fever,accounting for 59.2%.Systemic symptoms such as headache,fatigue,and muscle soreness were more common in the preschool and schoolage groups.Some children had vomiting and diarrhea,accounting for 12.3%and 9.5%,respectively.In the laboratory tests,the decreased white blood cells were most common in the infant group,accounting for 72.1%.Compared with the other three groups,the difference was statistically significant(P<0.001),and the other three groups showed more normal white blood cells.CRP was normal in 282 children,accounting for 74.8%.Alanine aminotransferase increased in 42 cases,creatine kinase isoenzyme increased in 56 cases.The incidence of abnormal liver function and myocardial damage was the highest in infant group,and the difference was statistically significant compared with infant group and preschool group(P<0.05).254 cases(67.4%)of children were infected with other mixed pathogens,with high detection rates of bacteria,146(38.7%),and mycoplasma,131(34.7%),and 42(11.1%)with mixed viruses.The incidence with mycoplasma infection in the preschool group was significantly higher than that in the other three groups,with a statistical significance(P<0.001).Most of the e

关 键 词：儿童 流感相关肺炎 混合感染 

分 类 号：R725.1[医药卫生—儿科]