甲型H1N1流感合并塑型性支气管炎患儿的病原学特点及临床特征  

Pathogenic and clinical characteristics of children with influenza A(H1N1)complicated with plastic bronchitis

作　　者：周明芝 王忻 蔡强[1] ZHOU Mingzhi;WANG Xin;CAI Qiang(Pediatrics Department of Yibin Second People's Hospital,Yibin,Sichuan 644000,China;不详)

机构地区：[1]宜宾市第二人民医院儿科,四川宜宾644000 [2]安徽省儿童医院内分泌代谢科

出　　处：《中国国境卫生检疫杂志》2025年第1期82-84,共3页Chinese Journal of Frontier Health and Quarantine

基　　金：四川省卫生厅科研项目(17PJ090)。

摘　　要：目的分析甲型H1N1流感合并塑型性支气管炎患儿的病原学特点及临床特征,为完善治疗方案提供参考。方法选取宜宾市第二人民医院和安徽省儿童医院2018年6月—2023年4月收治的138例甲型H1N1流感患儿作为研究对象,根据纤维支气管镜检查结果分为合并塑型性支气管炎组(30例)和非合并组(108例)。病原学筛查以痰培养或肺泡灌洗液培养为标准,临床特征分析包括实验室指标和影像学指标。结果合并组患儿甲型H1N1流感合并肺炎支原体感染的占比为56.67%,高于非合并组(35.19%,P<0.05)。合并组患儿中呼吸急促所占比例高于非合并组,差异有统计学意义(P<0.05)。合并组患儿的中性粒细胞占比、白细胞计数及C反应蛋白分别为(87.59±12.53)%、(18.53±3.67)×10^(9)、(35.62±4.78)mg/L,均高于非合并组(P<0.05),合并组患儿的CD4^(+)T淋巴细胞水平为(18.56±5.31)%,低于非合并组(P<0.05),合并组患儿中胸腔积液所占比例为33.33%,高于非合并组(14.81%,P<0.05)。结论甲型H1N1流感合并塑型性支气管炎患儿呼吸急促、胸腔积液等临床症状或体征更加明显,炎症反应和免疫反应程度更强烈。Objective To analyze the pathogenic characteristics and clinical features of children with influenza A(H1N1)complicated by plastic bronchitis,in order to provide reference for improving treatment strategies.Methods A total of 138children with influenza A(H1N1)admitted to Second People’s Hospital of Yibin City and Anhui Provincial Children’s Hospital from June 2018 to April 2023 were enrolled as the research subjects.According to the results of fiberoptic bronchoscopy examination,they were divided into combined plastic bronchitis group(30 cases)and noncombined group(108 cases).Pathogen screening was based on sputum culture or bronchoalveolar lavage fluid culture,and clinical feature analysis included laboratory indicator analysis and imaging indicators.Results The proportion of children with influenza A(H1N1)virus infection combined with Mycoplasma pneumoniae infection in the merged group was 56.67%,which was higher than that in the non-combined group(35.19%%.P<0.05).The proportion of children with rapid breathing in the combined group was higher than that in the non-combined group,and the difference was statistically significant(P<0.05),The proportion of neutrophils,white blood cell count,and C-reactive protein in the combined group were(87.59±12.53)%,(18.53±3.67)×10^(9),and(35.62±4.78)mg/L,respectively,which were higher than those in the non-combined group(P<0.05).The CD4^(+)T lymphocyte level in the combined group was(18.56±31)%,which was lower than that in the non-combined group(P<0.05).The proportion of pleural effusion in the combined group was 33.33%,which was higher than that the non-combined group(14.81%,P<0.05).Conclusion Children with influenza A(H1N1)combined with plastic bronchitis had more obvious clinical symptoms or signs such as shortness of breath and pleural effusion,and stronger inflammatory and immune reactions.

关 键 词：甲型H1N1流感 塑型性支气管炎 病原学特点 临床特征 

分 类 号：R183.3[医药卫生—流行病学] R725.6[医药卫生—公共卫生与预防医学]