特应性体质患儿腺病毒肺炎临床特征研究  

Clinical characteristics of adenovirus pneumonia in children with atopic constitution

作　　者：吕佳林 王文建[1] Lyu Jialin;Wang Wenjian(Department of Respiration,Shenzhen Children's Hospital,China Medical University,Shenzhen 518038,China)

机构地区：[1]中国医科大学深圳市儿童医院呼吸内科,518038

出　　处：《中国小儿急救医学》2024年第10期761-766,共6页Chinese Pediatric Emergency Medicine

摘　　要：目的总结特应性体质患儿腺病毒肺炎的临床特征。方法选取2018年1月1日至2022年12月31日在深圳市儿童医院诊断为腺病毒肺炎且有特应性体质的患儿为研究对象(特应性体质组),回顾性分析其基本信息、临床表现(包括症状、体征等)、实验室指标、合并感染病原体、主要治疗措施、并发症、重症肺炎发病率等临床资料,并与同期住院的非特应性体质腺病毒肺炎患儿(非特应性体质组)进行比较。结果共纳入190例特应性体质腺病毒肺炎患儿,其中男129例(67.90%),女61例(32.10%),中位年龄31(15,48)个月,住院时间6.00(4.00,8.25)d。与非特应性体质组相比,特应性体质组患儿在气促(37.9%比28.0%)、喘息(58.9%比27.2%)、哮鸣音(23.7%比9.5%)、胸腔积液(12.1%比20.5%)、轻度贫血(22.6%比31.1%)、合并感染(72.1%比62.9%)、超敏C-反应蛋白[11.99(3.55,27.67)mg/L比16.50(6.44,35.46)mg/L]、白蛋白[39.30(36.95,42.05)g/L比38.10(35.00,40.20)g/L]及吸氧治疗(36.8%比28.6%)方面差异均有统计学意义(P均<0.05)。多因素Logistic回归分析发现,热程>7.5 d、有气促及细湿啰音表现、血小板计数>390×109/L及天冬氨酸氨基转移酶>33.50 IU/L是特应性体质腺病毒肺炎患儿发生重症肺炎的独立危险因素(P均<0.05)。结论有特应性体质的腺病毒肺炎患儿住院期间出现气促、喘息及哮鸣音的发生率高于非特应性体质患儿,且更易合并感染,需要吸氧治疗的比例更高;热程长、有气促及细湿啰音表现、血小板及天冬氨酸氨基转移酶数值高可作为特应性体质患儿重症腺病毒肺炎的预测指标。Objective To summarize the clinical characteristics of adenovirus pneumonia in children with atopic constitution.Methods Children diagnosed with adenovirus pneumonia with atopic constitution at Shenzhen Children's Hospital from January 1,2018 to December 31,2022 were selected as the study subjects(atopic constitution group),and their clinical data,such as basic information,clinical manifestations(including symptoms,signs,etc.),laboratory indexes,co-infected pathogens,main treatment measures,complications,and incidence of severe pneumonia were retrospectively analyzed,and compared with children hospitalized with adenovirus pneumonia in non-atopic constitution during the same period(non-atopic constitution group).Results A total of 190 children with atopic somatic adenovirus pneumonia were included,including 129(67.90%)males and 61(32.10%)females,whose median age was 31(15,48)months,and hospitalization time was 6.00(4.00,8.25)days.The differences in shortness of breath(37.9%vs.28.0%),wheezing(58.9%vs.27.2%),rales(23.7%vs.9.5%),pleural effusion(12.1%vs.20.5%),anemia(22.6%vs.31.1%),co-infections(72.1%vs.62.9%),ultrasensitive C-reactive protein[11.99(3.55,27.67)mg/L vs.16.50(6.44,35.46)mg/L],albumin[39.30(36.95,42.05)g/L vs.38.10(35.00,40.20)g/L]and percentage of oxygen therapy(36.8%vs.28.6%)were statistically significant between the children in atopic group and nonatopic group(all P<0.05).Multifactorial Logistic regression analysis revealed that fever duration>7.5 days,manifestation of shortness of breath and fine wet rales,platelet count>390×109/L and aspartate aminotransferase>33.50 IU/L were independent risk factors for the development of severe pneumonia in children with atopic somatic adenovirus pneumonia(P<0.05).Conclusion Children with atopic adenovirus pneumonia have a higher incidence of shortness of breath,wheezing,and rales during hospitalization than the non-atopic group,are more susceptible to co-infections,and have a higher rate of needing oxygen therapy;prolonged duration of fever,shortness of breath,

关 键 词：特应性体质 腺病毒肺炎 临床特征 儿童 

分 类 号：R725.1[医药卫生—儿科]