儿童腺病毒肺炎的特点和重症肺炎的危险因素分析

Characteristics of Adenovirus Pneumonia in Children and Risk Factors of Severe Pneumonia

目的:探讨儿童腺病毒(human adenovirus,HADV)肺炎的临床及实验室特点和重症肺炎的危险因素。方法:选择2019年7月1日-12月31日在中山大学附属第五医院儿科住院的32例腺病毒肺炎患儿的临床资料进行回顾性分析,分析患儿的临床及实验室特点和重症肺炎的危险因素。结果:32例腺病毒肺炎患儿中,1~3岁13例(40.6%),15例(46.9%)合并1种以上的病原体感染,重症肺炎9例,占28.1%,非重症肺炎23例,占71.9%。单因素分析显示,重症肺炎患儿和非重症肺炎患儿年龄1~3岁占比、白细胞>10×10^9/L或<4×10^9/L占比、白蛋白水平比较,差异均有统计学意义(P<0.05);重症肺炎患儿和非重症肺炎患儿性别、结膜是否充血、是否合并肺炎支原体感染、是否合并1种及以上病原体感染、血红蛋白、血小板、降钙素原、C反应蛋白比较,差异均无统计学意义(P>0.05)。多因素Logistic分析结果显示,年龄1~3岁、白细胞>10×10^9/L或<4×10^9/L、白蛋白降低是引起重症肺炎发生的危险因素(P<0.05)。结论:年龄1~3岁、白细胞>10×10^9 /L或<4×10^9 /L、白蛋白降低的儿童腺病毒肺炎易发展为重症肺炎,对这些患儿应给予重点关注。

Objective:To investigate the clinical and laboratory characteristics of human adenovirus (HADV) pneumonia in children and risk factors for severe pneumonia.Method:The clinical data of 32 children with HADV pneumonia in the Fifth Affiliated Hospital of Sun Yat-sen University from July 1st to December 31st 2019 were retrospectively analyzed,and the clinical and laboratory characteristics in children,related factors of severe pneumonia were observed.Result:Among the 32 children with adenovirus pneumonia,13 cases (40.6%) were 1-3 years old,15 cases (46.9%) were infected with more than one pathogen,9 cases (28.1%) had severe pneumonia,and 23 cases (71.9%) had non-severe pneumonia.Univariate analysis showed that there were statistically significant differences in the proportion of children with severe pneumonia and children with non-severe pneumonia aged 1-3 years,the proportion of white blood cells > 10×10^9/L or < 4×10^9/L,and the albumin level (P<0.05).There were no statistically significant differences in gender,conjunctival congestion,mycoplasma pneumoniae infection,infection with one or more pathogens,hemoglobin,platelets,procalcitonin and c-reactive protein between children with severe pneumonia and children with non-severe pneumonia (P>0.05).The multivariate logistic analysis showed that age from 1-3 years,leukocyte >10×10^9/L or <4×10^9/L,albumin reduction were risk factors for severe pneumonia (P<0.05).Conclusion:Adenovirus pneumonia in children aged 1-3 years old,leukocyte >10×10^9/L or <4×10^9/L,albumin reduction are likely to develop into severe pneumonia,and should be given special attention.