儿童重症肺炎发生心肌损害的危险因素分析  

Analysis of Risk Factors for Myocardial Damage in Children with Severe Pneumonia

作　　者：李天笑 林文兰 杨芹[1] 穆然 李美娜 迟巍[1] Li Tianxiao;Lin Wenlan;Yang Qin(Nursing Department,Respiratory Center Clinical Department 1 Ward,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China)

机构地区：[1]首都医科大学附属北京儿童医院/国家儿童医学中心护理部,呼吸中心临床部一病区,北京100045

出　　处：《四川医学》2025年第3期327-331,共5页Sichuan Medical Journal

摘　　要：目的探讨重症肺炎患儿发生心肌损害的危险因素。方法回顾性收集我院2023年1月至2024年2月收治的509例重症肺炎患儿临床资料,其中153例患儿发生心肌损害,356例患儿未发生心肌损害。比较两组患儿基本资料、影像学及合并症资料、实验室指标;通过多因素Logistic回归分析检验重症肺炎患儿发生心肌损害的危险因素。结果发生心肌损害患儿发热天数、反复呼吸道感染、胸腔积液、营养不良、C反应蛋白(CRP)、红细胞沉降率(ESR)均高于未发生心肌损害患儿(均P<0.05),低钠血症占比低于未发生患儿(P<0.05)。多因素Logistic回归分析结果显示,病毒感染(OR=2.389,95%CI 1.143~4.993,P=0.021)、混合感染(OR=2.762,95%CI 1.148~6.647,P=0.023)、胸腔积液(OR=2.037,95%CI 1.126~3.683,P=0.019)、发热天数(OR=1.040,95%CI 1.002~1.079,P=0.041)、CRP(OR=1.009,95%CI 1.001~1.018,P=0.034)、ESR(OR=1.014,95%CI 1.003~1.024,P=0.009)是重症肺炎患儿发生心肌损害的危险因素。结论病毒感染、混合感染、合并胸腔积液、发热天数延长、CRP增高、ESR增高的重症肺炎患儿发生心肌损害的风险增加,对于重症肺炎患儿应积极检测并控制上述危险因素,以降低心肌损害的发生率。Objective To explore risk factors for myocardial damage in children with severe pneumonia.Methods From January 2023 to February 2024,clinical data of 509 children with severe pneumonia were retrospectively collected,including 153 children with myocardial damage and 356 children without myocardial damage.Basic information,imaging,comorbidity data and laboratory indicators were compared.Multivariate Logistic regression analysis was used to test risk factors for myocardial damage in children with severe pneumonia.Results The number of fever days,recurrent respiratory infections,pleural effusion,malnutrition,CRP and ESR were higher in children with myocardial damage(all P<0.05).The proportion of hyponatremia was lower in the non occurring group(P<0.05).Multivariate Logistic regression analysis showed that viral infection(OR=2.389,95%CI 1.143~4.993,P=0.021),mixed infection(OR=2.762,95%CI 1.148~6.647,P=0.023),pleural effusion(OR=2.037,95%CI 1.126~3.683,P=0.019),fever days(OR=1.040,95%CI 1.002~1.079,P=0.041),CRP(OR=1.009,95%CI 1.001~1.018,P=0.034),and ESR(OR=1.014,95%CI 1.003~1.024,P=0.009)were risk factors for myocardial damage in children with severe pneumonia.Conclusion Children with severe pneumonia could be at increased risk of developing myocardial damage due to viral infection,mixed infection,concomitant pleural effusion,prolonged fever days,elevated CRP and elevated ESR.For children with severe pneumonia,active detection and control of these risk factors should be carried out to reduce the incidence of myocardial damage.

关 键 词：重症肺炎 儿童 心肌损害 影响因素 

分 类 号：R725.6[医药卫生—儿科]