儿童重症腺病毒肺炎的临床特点研究

Research on clinical characteristics of severe adenovirus pneumonia in children

目的:分析儿童重症腺病毒肺炎(SAP)的临床特点。方法:2018年1月-2019年1月收治轻症SAP患儿40例,设为A组;选取同期重症监护室SAP患儿40例,设为B组。比较两组患儿临床特点。结果:B组小儿危重病例评分表(PCIS)评分明显低于A组,并发症种类及肺叶受累数量明显高于A组,差异有统计学意义(P<0.05);B组白细胞计数、血红蛋白、C反应蛋白及乳酸水平均高于A组,血小板数量明显低于A组,差异有统计学意义(P<0.05);B组乳酸脱氢酶(LDH)、谷草转氨酶(AST)及二氧化碳分压(PaCO2)水平均明显高于A组,而氧分压(PaO2)、白蛋白及氧合指数(PaO2/FiO2)水平均明显低于A组,差异有统计学意义(P<0.05);B组白细胞计数与C反应蛋白(CRP)升高的比例明显高于A组,差异有统计学意义(P<0.05)。结论:儿童SAP的炎性反应较为严重,导致细胞因子异常,且多伴随有肺内外部各类损害,发病早期LDH、AST、血小板数量、白细胞计数、白蛋白、CRP、PaO2、PaCO2、PaO2/FiO2等指标水平及PCIS评分均可以作为疾病预后的预测指标。

Objective:To study the clinical characteristics of severe adenovirus pneumonia(SAP)in children.Methods:From January 2018 to January 2019,40 cases of mild SAP were enrolled as A group.At same time,40 cases of SAP children in intensive care unit were enrolled as B group.The clinical characteristics of the two groups were compared.Results:The PCIS scale score of B group was significantly lower than that of A group,the number of pulmonary involvement and type of complications in B group were significantly higher than those in A group,the differences were statistically significant(P<0.05).The white blood cell count and hemoglobin,C reactive protein,lactic acid levels in B group were higher than those in A group,the number of platelets were significantly lower than those in A group,the difference was statistically significant(P<0.05).The LDH,AST and PaCO2 levels in B group were significantly higher than those in A group,PaO2,albumin and PaO2/FiO2 levels were significantly lower than those in the A group,the differences were statistically significant(P<0.05).The proportion of leukocyte count and CRP increased in B group were significantly higher than those in A group,the differences were statistically significant(P<0.05).Conclusion:The inflammatory response of children's SAP is more serious,which resulting in abnormal cytokines and most of them are accompanied by various kinds of damage inside and outside the lung,LDH,AST,platelet count,white blood cell count,albumin,CRP,PaO2,PaCO2,PaO2/FiO2 and other index levels and PCIS scores in the early stage of disease can be used as predictors of disease prognosis.