石家庄地区新型冠状病毒肺炎儿童患者的临床特征及不同年龄段的差异分析

Clinical characteristics of COVID-19 in pediatric patients in ShiJiaZhuang and differential analysis on different ages

目的分析石家庄地区不同年龄段儿童新型冠状病毒肺炎(coronavirus-2019,COVID-19)患者流行病学、临床特征和实验室检测指标的差异。方法连续性收集2021年1月11日~2月10日收治的COVID-19儿童患者127例,按生长发育特点分为4组:0~3岁(婴幼儿期,n=21)组,4~6岁(幼儿期,n=16)组,7~12岁(少儿期,n=53)组,13~17岁(青少年期,n=37)组。收集患儿的一般资料、流行病学数据及确诊后首次临床表现、实验室指标和影像学检测等,统计各检验指标异常率及组间差异,并纳入已有文献报道的新冠患儿的流行病学和实验室检查指标做汇总分析。结果102例(80.3%)患儿为家庭聚集性发病。80例(63.0%)儿童无典型症状。不同年龄组间性别差异无统计学意义(P>0.05)。0~3岁组发热、咳嗽发生率高于其他组,但差异无统计学意义(P>0.05)。胸部CT检查结果组间差异无统计学意义(P>0.05)。不同年龄组间pH值、阴离子间隙和碳酸氢根离子浓度差异无统计学意义(P>0.05)。13~17岁组二氧化碳分压发生率高于其他组(P<0.05)。血细胞分析结果显示,白细胞(WBC)和C-反应蛋白(CRP)的异常率组间差异无统计学意义(P>0.05),血小板(PLT)计数及异常率均随年龄增长而下降,组间差异显著(P<0.01)。血生化结果显示,63例(49.6%)患儿的β_(2)-微球蛋白(β_(2)-MG)高于正常值及62例(48.8%)前白蛋白(PALB)低于正常值,异常率组间差异有统计学意义(P<0.01),丙氨酸氨基转移酶(ALT)和门冬氨酸氨基转移酶(AST)的异常人数分别为8例和11例。结论各年龄段新冠患儿的临床症状、血气分析、血细胞分析和血生化均有不同程度的异常,不同年龄段的PaCO_(2)、PLT计数、β2-MG、PALB和AST的异常比例均存在显著差异。

Objective To analyze epidemiological characteristics,clinical characteristics and differences in laboratory-related parameters among different stages of children with coronavirus 2019(COVID-19)in Shijiazhuang.Methods the pediatric patients with COVID-19(n=127)were enrolled assigned to four groups based on developmental characteristics,including the 0~3 years old group(infants and young children,n=21),4~6 years old group(infancy,n=16),7~12 years old group(juvenile period,n=53)and 13~17 years old group(adolescence,n=37).The general information,epidemiological data,first confirmed clinical manifestation,laboratory indicators and imaging tests of children were collected,the abnormal rate of test indicators and difference between groups were counted,and epidemiological and laboratory test indicators of COVID-19 children reported in the literature were included for summary analysis.Results 102 cases(80.3%)were familial aggregation.80 children(63.0%)had no typical symptoms.There was no significant gender difference among different age groups(P>0.05).The incidence of fever and cough in the 0~3 years old group was higher than that in other groups,but the difference was not statistically significant(P>0.05).There was no significant difference in chest CT results among groups(P>0.05).There was no significant difference in pH value,anion gap and bicarbonate ion concentration among different age groups(P>0.05).The incidence of partial pressure of carbon dioxide in 13~17 years old group was higher than that in other groups(P<0.05).Blood cell analysis results showed that differences in the abnormal rate of white blood cells(WBC)and C-reactive protein(CRP)among groups were not statistically significant(P>0.05).Both the platelet count and abnormal rate decreased with the age,and significant differences among groups were found(P<0.01).Blood biochemistry results revealed that the level ofβ2 microglobulin(β2-MG)of 63(49.6%)children was higher than normal value,while the prealbumin(PALB)of 62(48.8%)cases was lower than normal value,and the difference in abnormal rate was statistically significant(P<0.01).The abnormal patients of ALT and AST transaminases were 8 and 11,respectively.Conclusion The abnormal parameters of clinical symptoms,blood gas,cell counts,organ biomarkers were observed in all age stages of pediatric patients with COVID-19,furthermore,significant differences were observed among four groups with respect to PaCO_(2),platelet count,β2-MG,PALB and AST levels.