儿童腺病毒合并流感病毒性肺炎的临床特点分析  

Clinical characteristics of adenovirus combined with influenza virus pneumonia in hospitalized children

作　　者：蔡月 卜欣欣[1] 凌岚[1] CAI Yue;BU Xinxin;LING Lan(Department of Pediatrics,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China)

机构地区：[1]南京医科大学第一附属医院儿科,江苏南京210029

出　　处：《临床肺科杂志》2025年第4期550-554,共5页Journal of Clinical Pulmonary Medicine

基　　金：江苏省医学会儿科医学第二期科研专项基金面上项目(SYH-32034-0102(2024006))。

摘　　要：目的研究住院儿童腺病毒合并流感病毒性肺炎的临床特征及分析重症肺炎的危险因素,以提高对儿童腺病毒合并流感病毒性肺炎的认识。方法收集2023年3月-2024年2月在南京医科大学第一附属医院儿科住院的468例腺病毒肺炎患儿临床资料。采用SPSS 23.0统计学软件分析腺病毒合并流感病毒性肺炎的临床特征及发生重症肺炎的危险因素。结果468例住院儿童腺病毒肺炎中,单纯腺病毒感染21.15%(99/468),腺病毒合并流感病毒感染14.10%(66/468),腺病毒合并流感病毒及支原体感染14.96%(70/468),腺病毒合并支原体感染29.91%(140/468),腺病毒合并呼吸道合胞病毒感染3.63%(17/468)。与单纯腺病毒感染的肺炎病例相比,腺病毒合并流感病毒感染的肺炎病例有更长的住院时间、更长的发热时间、更多的呕吐与腹泻等消化道症状、更易发生CRP升高(P<0.05)。Logistic回归分析结果显示,年龄小于5岁、入院后前3天未使用糖皮质激素、CT示肺大片实变或肺不张以及支气管镜下见痰栓堵塞或塑型支气管、D-二聚体升高等是腺病毒合并流感病毒感染的肺炎病例发生重症肺炎的独立危险因素(P<0.05)。结论及早应用激素可改善预后,小于5岁、早期未使用糖皮质激素、肺实变或肺不张以及痰栓堵塞或塑型支气管、D-二聚体升高等是腺病毒合并流感病毒感染的肺炎病例发生重症肺炎的独立危险因素。Objective To study the clinical characteristics of adenovirus combined with influenza virus pneumonia in hospitalized children and analyze the risk factors of sever adenovirus combined with influenza virus pneumonia to improve the understanding of adenovirus combined with influenza virus pneumonia.Methods The clinical data of 468 children with adenovirus pneumonia hospitalized in the First Affiliated Hospital of Nanjing Medical University from March 2023 to February 2024 were collected.The clinical features of adenovirus combined with influenza virus pneumonia and the risk factors of severe adenovirus combined with influenza virus pneumonia were analyzed by SPSS 23.0 statistical software.Results Among the 468 children with adenovirus pneumonia,there were 21.15%of adenovirus infection,14.10%of adenovirus combined with influenza virus infection,14.96%of adenovirus combined with influenza virus and mycoplasma infection,adenovirus combined with mycoplasma infection,29.91%of adenovirus combined with respiratory syncytial,and 3.63%virus infection.Compared with adenovirus pneumonia,pneumonia cases with adenovirus and influenza virus infection had longer hospitalization time,longer fever time,more gastrointestinal symptoms such as vomiting and diarrhea,and higher CRP(P<0.05).Logistic regression analysis showed that the independent risk factors of sever adenovirus combined with influenza virus pneumonia were age<5,without using hormone in the first three days after hospitalization,large areas of pulmonary consolidation or atelectasis,obstruction or molding of sputum thrombus under bronchoscope and higher D-dimer(P<0.05).Conclusion Adenovirus combined with influenza virus pneumonia can be improved by early use of hormones.The independent risk factors of sever adenovirus combined with influenza virus pneumonia include age of onset less than 5 years old,without using hormone early,pulmonary consolidation or atelectasis,obstruction or molding of sputum thrombus under bronchoscope and higher D-dimer.

关 键 词：腺病毒 流感病毒 临床特征 重症肺炎 

分 类 号：R725.6[医药卫生—儿科]