河南省某医院40例新生儿不同亚型重症流感的临床特征  

Clinical characteristics of different subtypes of severe influenza in 40 neonates from a hospital in He'nan Province

作　　者：贾璨阳 贾婉玉 付书琴[1] 宋春兰 成怡冰 JIA Canyang;JIA Wanyu;Fu Shuqin;SONG Chunlan;CHENG Yibing(Children's Hospital Affiliated to Zhengzhou University,He'nan Children's Hospital,Zhengzhou Children's Hospital,Zhengzhou,He'nan 450000,China)

机构地区：[1]郑州大学附属儿童医院,河南省儿童医院郑州儿童医院,河南郑州450000

出　　处：《中国热带医学》2024年第7期767-771,共5页China Tropical Medicine

基　　金：河南省联合共建项目(No.LHGJ20220734);2023年河南省儿童感染与危重症诊治工程研究中心开放课题(No.ERC202304)。

摘　　要：目的对比分析新生儿不同亚型重症流行性感冒(简称“流感”)的临床特征和诊疗情况,以期为新生儿重症流感诊疗提供参考。方法选取2019—2023年在郑州大学附属儿童医院新生儿病房住院治疗的40例重症流感患儿为研究对象,根据病毒亚型分为甲型流感组(简称“甲流”,n=23)和乙型流感组(简称“乙流”,n=17),回顾性分析对比2组患儿的一般资料、临床表现、实验室检查、并发症和治疗情况等。结果重症甲流病例住院天数长于乙流;重症甲流新生儿有发热表现者比例高于乙流新生儿,且发热热峰为38.1~39℃人数占比高于乙流;乙流重症感染后消化道症状(包括呕吐、腹泻)表现更为明显,引起脱水的患儿相对更多;甲流病例肌酸激酶同工酶异常(>25 U/L)者比例高于乙流;2组差异均有统计学意义(均P<0.05)。不同亚型流感重症感染后,患儿其他临床表现、肺部感染和呼吸衰竭并发症发生率、外周血白细胞计数和分类、天冬氨酸转氨酶异常(>40 U/L)、丙氨酸转氨酶异常(>40 U/L)、肌酸激酶异常(>200 U/L)者比例以及乳酸脱氢酶值等差异均无统计学意义(均P>0.05)。治疗方面,在发病48 h内得到奥司他韦治疗的病例以甲流为主,经奥司他韦治疗后,患儿体温在24 h内恢复正常者甲流比例相对较高,体温在24~72 h内恢复正常者乙流比例相对较高,2组差异均有统计学意义(P<0.05)。结论新生儿重症流感高发季节为冬春季。重症病例中,甲流发热更加明显,更易导致心肌细胞受损,能更及时接受奥司他韦治疗,且用药后退热速度相对更快,乙流消化道症状较为多见。Objective To compare and analyze the clinical characteristics,diagnosis,and treatment of different subtypes of severe influenza in neonates to provide a reference for the diagnosis and treatment of neonatal severe influenza.Methods A cohort of 40 neonates with severe influenza who were hospitalized in the neonatology ward of Children′s Hospital Affiliated to Zhengzhou University between January 2019 to December 2023 were selected and divided into two groups based on the virus subtype:influenza A(n=23)and influenza B(n=17).A retrospective analysis was conducted to compare general information,clinical manifestations,auxiliary examinations,complications,and treatment outcomes of neonates with severe influenza A and B infection.Results The number of days of hospitalization was longer in cases of influenza A than that of influenza B.The proportion of neonates with severe influenza A who exhibited fever was higher than that for influenza B,and a higher percentage of those with fever had peak temperatures ranging from 38.1℃to 39℃.Gastrointestinal symptoms,including vomiting and diarrhea leading to dehydration,were more evident in severe influenza B cases.The proportion of influenza A cases with abnormal creatine kinase-MB isoenzyme levels(>25 U/L)was higher than that of influenza B,and the differences were statistically significant(P<0.05).There were no significant differences between the two types of influenza in other clinical manifestations,the incidence of pneumonia/respiratory failure complications,peripheral blood leukocyte count and classifications,the proportion of abnormal aspartate aminotransferase(AST)(>40 U/L),alanine aminotransferase(ALT)(>40 U/L),and creatine kinase(CK)(>200 U/L),and lactate dehydrogenase(LDH)values(all P>0.05).In terms of treatment,neonates treated with Oseltamivir within 48 hours of onset mainly suffered from influenza A.Among those treated with Oseltamivir,the proportion of influenza A cases whose body temperature returned to normal within 24 hours was relatively higher,whereas,fo

关 键 词：新生儿 流行性感冒 重症感染 临床特征 

分 类 号：R373.13[医药卫生—病原生物学]