儿童嗜肺军团菌合并流感病毒感染的临床研究

Clinical study of Legionella pneumophila combined with influenza infection in children

目的:了解儿童流感合并嗜肺军团菌感染的临床特点,并进行研究总结。方法:收集本科室2014年1月~2020年7月收治的嗜肺军团菌感染的病例,其中诊断为流感合并嗜肺军团菌(LP+Ⅳ)感染30例,单纯嗜肺军团菌感染(LP)20例。对50例患儿进行回顾性分析,比较两组患儿临床表现,相关辅助检查结果和住院时间进行比较。结果:LP+Ⅳ组患儿发热、热峰高(≥39.5℃)、肺部阳性体征(干、湿性啰音)发生例数较LP感染组多,差异有统计学意义;LP+Ⅳ组WBC升高、hCRP升高、肌酸激酶同工酶升高、肝功能异常、胸片阳性者高于LP组,差异有统计学意义;LP+Ⅳ组住院时间长于LP组,差异有统计学意义。结论:儿童患流感合并嗜肺军团菌感染的临床表现较单独嗜肺军团菌感染者更加突出,肺外表现及多脏器功能损害的情况也更易出现,临床医师应加以重视。

Objective To summarize the clinical characteristics of influenza combined with Legionella pneumophila infection in children.Methods 50 cases of Legionella pneumophila infections admitted to the department of paediatrics from January 2014 to July 2020 in Tongling People’s Hospital were enrolled,of which 30 cases were diagnosed with influenza combined with Legionella pneumophila(LP+Ⅳ)infection,and 20 cases were diagnosed with Legionella pneumophila(LP)infection only.Retrospective analysis of these 50 patients was conducted to compare the clinical manifestations,related auxiliary examination results and hospital stay.Results There were more cases of fever,fever peak(≥39.5℃)and positive signs of lungs(dry and wet rales)in the LP+Ⅳgroup than in the LP infection group,the difference was statistically significant;The cases with increased WBC,increased hCRP,increased CK-MB,abnormal liver function,and positive chest radiographs in the LP+Ⅳgroup were higher than that in the LP group;hospital stay in the LP+Ⅳgroup also longer than the LP group,the difference was statistically significant.Conclusion The clinical manifestations of children with influenza combined with Legionella pneumophila infection are more prominent than those with Legionella pneumophila infection alone,and extra-pulmonary manifestations and multiple organ dysfunction are more likely to occur.Clinicians should pay attention to them.