儿童腺病毒肺炎合并闭塞性细支气管炎的危险因素及预后分析  

Risk Factors and Prognosis of Occlusive Bronchiolitis Associated with Adenovirus Pneumonia in Children

作　　者：张莉[1] 李丹[1] 周婷 裴成 夏磊[1] ZHANG Li;LI Dan;ZHOU Ting;PEI Cheng;XIA Lei(Department of Neonatology,Songzi People’s Hospital,Jingzhou,Hubei 434200,China)

机构地区：[1]湖北省松滋市人民医院新生儿科,湖北荆州434200

出　　处：《中国医药指南》2025年第11期72-74,共3页Guide of China Medicine

摘　　要：目的探讨儿童腺病毒肺炎合并闭塞性细支气管炎的预后分析及危险因素。方法选取2017年1月至2023年12月在湖北省松滋市人民医院诊断为腺病毒肺炎的308例患儿的病历资料,依据是否伴随闭塞性细支气管炎这一并发症,将其划分为两组。研究组为并发闭塞性细支气管炎的患儿,对照组为未并发闭塞性细支气管炎的腺病毒肺炎患儿。结果47.08%(145/308)的腺病毒肺炎患儿合并闭塞性细支气管炎。单因素分析结果揭示,对比两组患儿在发热时长、急性期是否存在肺部哮鸣音、呼吸机辅助呼吸的时长、起始全身性糖皮质激素治疗的时机、住院周期、过往相关病史、急性期乳酸脱氢酶(LDH)水平方面,差异有统计学意义(P<0.05)。对相关因素Logistic回归分析显示,呼吸机使用时间、既往病史、是否有急性期肺部喘鸣音是儿童腺病毒肺炎并发闭塞性细支气管炎的独立危险因素。结论儿童腺病毒肺炎并发闭塞性细支气管炎的发生率高且预后差。急性期患儿若存在长时间呼吸机依赖、肺部喘鸣音及既往喘息病史,其并发风险显著增加。早期识别和干预这些危险因素,对改善预后意义重大。Objective To explore the risk factors and prognostic analysis of adenovirus pneumonia combined with occlusive fine bronchiolitis in children.Methods A total of 308 children diagnosed with adenovirus pneumonia in Songzi People’s Hospital,Hubei Province,from January 2017 to December 2023 were selected.Based on whether they had bronchiolitis obliterans as a complication,the children were divided into two groups.The study group included children with adenovirus pneumonia complicated by bronchiolitis obliterans,while the control group included children with adenovirus pneumonia without bronchiolitis obliterans.Results 47.08%(145/308)of the children with adenovirus pneumonia were comorbid with occlusive fine bronchiolitis.The results of univariate analysis revealed that comparing the two groups of children showed statistically significant differences in terms of duration of fever,presence of pulmonary rales during the acute phase,duration of ventilator-assisted respiration,timing of initiation of systemic glucocorticoid therapy,hospitalization period,past relevant medical history,and lactate dehydrogenase(LDH)level during the acute phase(P<0.05).Multifactorial Logistic regression analysis showed that the duration of ventilator use,past medical history,and the presence of acute-phase lung wheeze were independent risk factors for adenoviral pneumonia complicating occlusive bronchiectasis in children.Conclusions Adenovirus pneumonia in children is highly associated with bronchiolitis obliterans,which has a poor prognosis.In the acute phase,extended ventilator support,audible lung wheezes,and a history of wheezing significantly increase the risk of this complication.Early identification and intervention of these risk factors are crucial for improving prognosis.

关 键 词：腺病毒肺炎 闭塞性细支气管炎 危险因素 预后 

分 类 号：R562.21[医药卫生—呼吸系统] R725.6[医药卫生—内科学]