儿童甲型流感病毒肺炎临床特征及危险因素

linical characteristics of children with influenza A virus pneumonia and risk factors

目的分析甲型流感病毒肺炎患儿的发病现况、高危因素。方法回顾性收集186例2020年6月-2022年6月河南省儿童医院收治的甲型流感病毒感染患儿为研究对象,根据患儿是否发生肺炎,分为肺炎组(n=42)和非肺炎组(n=144)。患儿入院就诊时,采集其鼻咽分泌物、肺部痰液进行病原检测,收集两组临床资料,统计甲型流感病毒肺炎患儿的发病现况,并利用单因素和多因素Logistic回归法分析其危险因素。结果甲型流感病毒肺炎在儿童中的发病率为22.58%,其占比前三的年龄段为>12且≤36个月(42.86%)、>6且≤12个月(26.19%)、>36且≤60个月(19.05%),病情程度以轻度为主,临床症状多为呼吸道症状和肺部出现啰音,胸部影像病变部位多为双肺,易合并细菌感染;男性、发病至首次就诊时间>48 h、发病至抗病毒治疗时间>48 h、肺部出现啰音是甲型流感病毒肺炎的危险因素(P<0.05)。结论儿童甲型流感病毒肺炎的发病率较高,以轻度肺炎、双肺病变为主,易合并细菌感染;男性、发病至首次就诊或抗病毒治疗时间长、肺部出现啰音的儿童发病风险较高,据此可给予针对性的预防干预及治疗措施。

OBJECTIVE To analyze the status and risk factors for influenza A virus pneumonia in children.METHODS A total of 186 children infected with influenza A virus in the Henan Children′s Hospital from Jun 2020 to Jun 2022 were retrospectively collected as the research subject.According to whether the patients developed pneumonia,they were divided into the pneumonia group(n=42)and the noon-pneumonia group(n=144).Nasopharyngeal secretions and pulmonary sputum were collected for pathogen detection when the child patients were admitted to hospital.Clinical data of the two groups were collected to analyze the morbidity status of the children with influenza A viral pneumonia,and its risk factors were analyzed by univariate and multivariate logistic regression methods.RESULTS The incidence of influenza A viral pneumonia in children was 22.58%,and the top three age groups were>12 and≤36 months(42.86%),>6 and≤12 months(26.19%),and>36 and≤60 months(19.05%).The severity of the disease was mainly mild,with the clinical main symptoms of respiratory symptoms and lung rales,chest imaging lesions of both lungs,and the combination of bacterial infection.Male,time from onset to the first visit>48 h,time from onset to antiviral treatment>48 h,lung rales were risk factors for influenza A viral pneumonia(P<0.05).CONCLUSION The incidence of influenza A viral pneumonia in children is relatively high,with the main symptoms of mild pneumonia,lesions in both lungs,and combination of bacterial infection.Men,children with a long time from onset to first visit or antiviral treatment,and lung rales had a higher risk of developing the disease.Therefore,targeted preventive interventions and treatment measures could be given accordingly.