153例住院儿童甲型流感病毒肺炎及混合感染的临床特征

Clinical characteristics of 153 hospitalized children with influenza A virus pneumonia and mixed infection

目的探讨住院儿童甲型流感病毒肺炎合并其他病原菌感染的临床特征。方法通过回顾性研究方法,分析2021年6月—2023年6月广州市妇女儿童医疗中心住院治疗的153例甲型流感病毒肺炎患儿的临床资料,针对有无合并其他病原菌感染,分为混合感染组及非混合感染组两组,分别为98例及55例,分析并对比两组的临床特征。结果甲型流感病毒肺炎患儿以发热、咳嗽、呕吐/腹泻等症状为主,其中混合感染组患儿呕吐/腹泻症状占比高于非混合感染组(P<0.05);两组患儿其他症状及并发症对比差异无统计学意义(P>0.05);儿童甲型流感病毒肺炎患儿检出合并细菌感染的患儿65例(29.41%),合并肺炎支原体感染的患儿33例(21.57%);合并病毒感染的患儿20例(13.07%)。与非混合感染组比较,混合感染组患儿乳酸脱氢酶水平更高,白细胞计数<4×10^(9)/L的人数占比更少(P<0.05);其他实验室指标对比差异无统计学意义(P>0.05);经过抗病毒及对症治疗后,150例(98.04%)患儿痊愈出院,3例出现严重并发症,其均伴有其他病原菌感染。与非混合感染组比较,混合感染组患儿住院天数更长、住院费用更高(P<0.05);其他预后指标对比差异无统计学意义(P>0.05)。结论甲型流感病毒肺炎患儿易感染其他的病原菌,导致疾病治疗难度加大,因此临床要提高警惕,以防混合感染情况发生,尽早采取有效的诊治措施,提高疾病早期治愈率。

Objective To explore the clinical characteristics of hospitalized children with influenza A virus pneumonia complicated with other pathogens.Methods The clinical data of 153 children with influenza A virus pneumonia hospitalized in Guangzhou Women and Children Medical Center in the past two years(June 2021~June 2023)were analyzed retrospectively.According to whether they were infected with other pathogens,they were divided into mixed infection group and non-mixed infection group,with 98 cases and 55 cases respectively.The clinical characteristics of the two groups were analyzed and compared.Results Fever,cough,vomiting and diarrhea were the main symptoms in children with influenza A virus pneumonia,and the proportion of vomiting and diarrhea in children with mixed infection group was higher than that in children without mixed infection group(P<0.05).There was no significant difference in other symptoms and complications between the two groups(P>0.05).There were 65 children(29.41%)with influenza A virus pneumonia and 33 children(21.57%)with mycoplasma pneumonia,20 children(13.07%)with virus infection.Compared with non-mixed infection group,the level of lactate dehydrogenase in children with mixed infection group was higher,and the proportion of children with white blood cell count<4×10^(9)/L was less(P<0.05).There was no significant difference in other laboratory indexes(P>0.05).After antiviral and symptomatic treatment,150 cases(98.04%)were cured and discharged,and 3 cases had serious complications,all of which were accompanied by other pathogens.Compared with non-mixed infection group,children in mixed infection group had longer hospitalization days and higher hospitalization expenses(P<0.05).There was no significant difference in other prognostic indicators(P>0.05).Conclusions Children with influenza A virus pneumonia are easily infected with other pathogens,which makes it more difficult to treat the disease.Therefore,we should be vigilant in clinic to prevent mixed infection and take effective diagnosis and treatment measures as soon as possible to improve the early cure rate of the disease.