成人麻疹合并肺炎的临床特征观察

Clinical characteristics of adult measles complicated with pneumonia

目的 探讨成人麻疹患者合并肺炎的临床特征。方法 选取2010年6月至2022年6月首都医科大学附属北京佑安医院成人麻疹患者147例,根据是否合并肺炎分为肺炎组和非肺炎组,比较两组临床特征。结果 147例患者中男72例,女75例,年龄18~61岁,平均(33.5±9.7)岁,其中肺炎组69例,非肺炎组78例。两组性别、年龄、既往病史、临床症状(体温、咳嗽、流涕、结膜炎、全身皮疹及柯氏斑)、并发症(呼吸衰竭、心肌炎、胃肠炎及麻疹脑炎)、血常规(WBC、中性粒细胞、淋巴细胞及PLT)、炎症指标、肝功能(T-BIL、D-BIL、AST、ALT、ALB)、肾功能(BUN、SCr)、使用抗病毒治疗比例及住院天数的比较,差异均无统计学意义(P>0.05)。肺炎组TP低于非肺炎组[66.30(61.00, 71.50)g/L比69.00(65.20,74.50)g/L],使用抗生素治疗比例高于非肺炎组(81.16%比52.56%),差异均有统计学意义(P <0.05)。结论 合并肺炎未对成人麻疹的临床特征带来明显影响,抗生素的使用需要更精细化的管理,避免预防性使用。

Objective To explore the clinical characteristics of adult measles patients complicated with pneumonia.Methods A total of 147 adult measles patients in Beijing Youan Hospital Affiliated to Capital Medical University from June 2010 to June 2022 were selected and divided into the pneumonia group and non-pneumonia group according to whether pneumonia was complicated or not,and the clinical characteristics of the two groups were compared.Results There were 72 males and 75 females among the 147 patients,aged from 18 to 61 years,with an average of(33.5±9.7)years old,including 69 cases in the pneumonia group and 78 cases in the non-pneumonia group.There were no significant differences in gender,age,comorbidities,clinical symptoms(temperature,cough,rhinorrhea,conjunctivitis,rash,and Koplik's spots),complications(respiratory failure,myocarditis,gastroenteritis,and measles encephalitis),routine blood test(WBC,neutrophils,lymphocytes,and PLT),inflammatory indicators,liver function(T-BIL、D-BIL、AST、ALT、ALB),renal function(BUN、SCr),the proportion of antiviral treatment,and the length of hospital stay(all P>0.05).TP in the pneumonia group was lower than that in the non-pneumonia group[66.30(61.00,71.50)g/L vs.69.00(65.20,74.50)g/L],and the proportion of antibiotics treatment was higher than that in the non-pneumonia group(81.16%vs.52.56%),and the differences were statistically significant(both P<0.05).Conclusions Complicated pneumonia has no obvious effect on the clinical characteristics of adult measles,and the use of antibiotics needs more refined management to avoid preventive use.