新疆喀什地区40例儿童甲型流感住院病例的临床特征

Clinical characteristics of 40 hospitalized children with type A influenza virus in Kashgar region,Xinjiang,China

目的分析新疆喀什地区40例儿童甲型流感病毒感染住院病例的临床特征.方法收集2023年2-6月陆军第九四七医院经流感病毒核酸检测证实为甲型流感病毒感染收治住院的40例患儿的临床资料进行分析.结果发病年龄3个月~12岁,中位年龄4岁,其中0~5岁28例(70.00%),春季为发病高峰,以发热(87.50%)、咳嗽(90.00%)等症状为主;合并症包括肺炎24例(60.00%),其中0~5岁儿童28例(70.00%),与6~12岁(12例,30.00%)相比差异有统计学意义(P<0.05),急性喉炎2例,心肌损害5例,热性惊厥3例,电解质紊乱2例,肌炎1例,严重脓毒症1例等;单一流感病毒感染30例(75.00%),混合感染10例(25.00%),包括支原体感染4例,细菌感染6例;32例患儿口服奥司他韦颗粒,其中发热48 h内服用11例,48 h后服用21例;48 h内服用奥司他韦组发热时间及住院时间均低于48 h后服用组(P均<0.05);所有患儿均治愈.结论甲型流感感染住院患儿以5岁以下儿童为主;症状无特异性,以高热、咳嗽为主要表现,可出现多种合并症,肺炎最常见;可混合其他病原感染;早期诊断、早期治疗,一般预后良好.

OBJECTIVE To investigate the clinical characteristics of hospitalized children with type A influenza virus post-epidemic.METHODS Clinical data of 40 hospitalized children with influenza A virus confirmed by influenza virus nucleic acid testing at the 947th Hospital of Army during the period from Feb.to Jun.2023 were collected and analyzed.RESULTS The onset age was from 3 months to 12 years old,with a median age of 4 years old,of which 28 cases(70.00%)were aged 0 to 5 years,with spring being the peak of the onset of the disease.Fever and cough were the main clinical manifestations.Comorbidities included pneumonia in 24 cases(60.00%),inclu-ding 28 cases(70.00%)in children aged 0-5 years,with a significant difference compared to those aged 6-12 years(12 case,30.00%)(P<0.05),acute laryngitis in 2 cases,myocardial injury in 5 cases,febrile convulsion in 3 cases,electrolyte disorders in 2 cases,myositis in 1 case,and severe sepsis in 1 case.There were 30 cases(75.00%)of single influenza virus infection,and 10 cases(25.00%)of mixed infection,including 4 cases of my-coplasma infection and 6 cases of bacterial infection.Thirty-two children were given oseltamivir granules orally,of which 11 cases were given within 48 h of fever and 21 cases were given after 48 h.The fever time and hospitaliza-tion time in the group given oseltamivir granules within 48 h were lower than those in the group given medicine af-ter 48 h.All children were cured.CONCLUSION The majority of hospitalized children with influenza virus type A were children under 5 years old.The symptoms were non-specific,with high fever and cough as the main manifes-tations,and multiple comorbidities might occur,with pneumonia being the most common.Children infected with influenza A might have a mixture of other pathogenic infections.Early diagnosis and treatment generally had a good prognosis.