儿童重症腺病毒肺炎危险因素分析

Risk factors of severe adenovirus pneumonia in children

目的分析儿童重症腺病毒肺炎的相关危险因素。方法回顾性分析小儿腺病毒肺炎患儿111例,其中重症腺病毒肺炎48例,非重症腺病毒肺炎63例。单因素分析后,采用多因素logistic回归分析,找出与重症腺病毒肺炎相关的危险因素。结果单因素回归分析显示,在起病3天内出现喘息(P=0.002)、有喘息史(P=0.010)、合并巨细胞病毒感染(P=0.000)、高热(P=0.041)是发生重症腺病毒肺炎的危险因素。多元logistic回归分析显示疾病起病3天内喘息(P=0.046)、合并巨细胞病毒感染(P=0.021)是重症腺病毒肺炎发生的独立危险因素。结论当腺病毒肺炎患儿合并巨细胞病毒感染或者起病3天内出现喘息症状时,腺病毒肺炎更有可能发展为重症肺炎。对于合并以上特征的腺病毒肺炎患儿应早期积极干预。

Objective To investigate and analyze relevant risk factors for severe pneumonia in children with adenovirus infection.Methods A retrospective study of children with adenovirus infection was performed in 48 cases that developing SAP and 63 cases not developing SAP in Anhui Province Hospital from June 2018 to December 2019.The multivariate logistic regression analysis was used to identify factors which were significantly associated with development of SAP after the univariate analysis.Results In patients with SAP,wheezing history(P=0.01),wheezing in the first 3 days(P=0.001),hyperpyrexia(P=0.041)and co-infection with cytomegalovirus(P=0.000)were more common.Two factors were independently associated with development of SAP,which were co-infection with cytomegalovirus(P=0.021)and wheezing at early stage(P=0.046).Conclusion Children with adenovirus pneumonia who have co-infection with cytomegalovirus and have wheezing in the first 3 days are more likely to develop severe pneumonia.Patients with such characteristics should have a more active treatment.