Brain Complications with Influenza Infection in Children

Objectives: To summarize the characteristics and research progress of influenza-associated brain complications in children and provide references for early diagnosis and brain protection treatment. Methods: Studied published articles of influenza-associated neurocomplications in children from PubMed and summarizes them from epidemiology, clinical manifestations, diagnosis and treatment, and basic research progress. Results: Common brain complications in flu-children include febrile seizures, influenza-associated encephalopathy (IAE), acute or post-influenza encephalitis, and the most severe condition is acute necrotizing encephalopathy (ANE). However, the mechanism and relevant factors of influenza-associated brain damage have not been elucidated. Conclusion: Influenza could be accompanied by various brain lesion complications in dif ferent stages of the disease, some of which are life-threatening or leave severe neurological sequelae, such as ANE. Due to different brain injury mechanisms, specific early diagnosis and brain protection treatment for different complications are unclear or unanimous. Therefore, further classification and basic research are needed.

Characteristics and Mortality Risk Factors of Influenza-Associated Encephalopathy/Encephalitis in Children in a Tertiary Pediatric Hospital in China, 2016-2019

Background: Seasonal influenza associated neurological complications had high mortality and morbidity rates in children. In this study, we aimed to investigate the clinical characteristics and mortality risk factors in children with influenza-associated encephalopathy. Methods: Retrospectively analyze the clinical data, laboratory tests, and imaging examinations of 68 children diagnosed with influenza-associated encephalopathy from January 2016 to December 2019 at Guangzhou Women and Children’s Medical Center, and the cases were divided into survival and non-survival groups by disease outcome and analyzed between two groups. Chi-square test or Mann-Whitney rank sum test was used for comparison between groups, and multivariate Logistic regression analysis was used for the analysis of risk factors for death. Results: Among the 68 children with influenza-associated encephalopathy, 40 were male, and 28 were female, aged from 3 months to 13 years, of which 66.18% (45/68) were under 5 years old. Pathogenetic tests showed that influenza virus type A accounted for 63.24% (43/68), and influenza virus type B accounted for 36.76% (25/68). Typical brain MRI changes in childhood influenza-associated encephalopathy were bilateral symmetrical lesions of the thalamus, basal ganglia, brainstem, and cerebellum. 68 patients had a mortality rate of 20.59% (14/68), with a significantly higher proportion of fever peak > 39°C, Acute Disturbance of Consciousness (ADOC), and cardiac arrest in the non-survival group than in the survival group (P < 0.05). Laboratory tests showed significantly higher in Alanine Aminotransferase (ALT), Aspartate Transaminase (AST), Creatinine Kinase (CK), Lactate Dehydrogenase (LDH), lactate, and C-Reactive Protein (CRP). And CSF protein levels in the non-survival group compared with the survivor (P < 0.05), among them, elevated ALT, AST, LDH, and CSF protein were independent high-risk factors for death from influenza-associated encephalopathy. Conclusions: Children under 5 years of age with influenza are prone to combine neurological complications and have a higher mortality rate. Significant elevations in ALT, AST, LDH, and CSF proteins predict death from influenza-associated encephalopathy in children.

Children, Influenza, Encephalopathy, Clinical Characteristics, Laboratory Index

Background: To explore the early clinical features and laboratory findings of influenza-associated acute necrotizing encephalopathy (IANE). Methods: The demographics data, clinical manifestations, and laboratory indicators of cases diagnosed with IANE and influenza with febrile convulsions (FS), respectively, admitted to Guangzhou Women and Children’s Medical Center from January 2016 to January 2020 were retrospectively analyzed. Results: Among the 25 cases of IANE, there were 9 males and 16 females, aged 3 to 6 years. The mortality rate was 40.00% (10/25). Influenza virus type A in 9 cases (36.00%) and influenza virus type B in 10 cases (40.00%). The main clinical manifestations of children with IANE were acute disorders of consciousness (64.00%, 16/25) and convulsions (72.00%, 18/25), which were statistically significant when compared with the FS group (P < 0.05). Typical changes on cranial MRI of IANE were cerebral edema, typically with symmetric necrosis of the thalamus and other brain structures. Significant differences (P < 0.05) existed between the IANE and FS groups in laboratory indicators for ALT, AST, CK-MB, LDH, cerebrospinal fluid (CSF) microprotein, CSF LDH, which were above the normal reference range. In addition, logistic regression analysis showed that LDH ≥ 348.5 U/L predicted a significantly higher risk of IANE. Conclusions: Children with influenza present early with acute impairment of consciousness or convulsive seizures, or with elevated AST, ALT, CK-MB, LDH, and CSF protein and CSF LDH, especially if blood LDH is ≥348.5 U/L, should be closely evaluated and alerted to the possibility of IANE.

Risk Factors of Influenza-Associated Necrotizing Encephalopathy in Children

Objective: A case-control study of Influenza-Associated Necrotizing Encephalopathy (IANE) in children was conducted to explore the risk factors for the diagnosis of IANE, and to provide a predictive reference for the diagnosis of IANE. Methods: The children with IANE who received treatment in our hospital from January 2016 to December 2020 were selected as the study group, and the children with Influenza-Associated Encephalopathy (IAE) group who received treatment in the same period were selected as the control group. The blood biochemical, coagulation function and cerebrospinal fluid test results of the two groups were analyzed by univariate analysis. Receiver Operating Characteristic curve (ROC) analysis was used to determine the optimal threshold point of each index for the indicators with statistically significant differences in univariate analysis results, and multivariate Logistic stepwise regression analysis was performed according to the optimal threshold points. Results: In the IANE group, there were 32 children, including 20 males and 12 females, aged 60 (35, 84) months. There were 40 children in IAE group, including 26 males and 14 females, aged 58 (23, 97) months. Univariate results showed that serum Lactate Dehydrogenase (LDH), Cerebrospinal Fluid Lactate Dehydrogenase (CSF LDH) and Cerebrospinal Fluid Protein (CSF PRO) in the IANE group were significantly higher than those in the IAE group, and the difference between the two groups was statistically significant (P < 0.001). The optimal threshold points of blood LDH, CSF LDH and CSF PRO by ROC curve analysis were 535 U/L, 67 U/L and 0.49 g/L, respectively. Further Multivariate Logistic stepwise regression analysis showed that LDH > 535 U/L (OR = 31.264, 95% CI: 5.892 - 165.878, P < 0.001) and CSF PRO > 0.49 g/L (OR = 7.695, 95% CI: 1.052 - 56.305, P = 0.044) were independent risk factors for IANE. Conclusion: For children with influenza whose neurological symptoms appear rapidly and persist in the early stages of the disease, blood LDH > 535 U/L and CSF PRO > 0.49 g/L are independent risk factors for IANE.

Immunological Responses against Different Lineages of Influenza B Antigen in School Children during Two Consecutive Seasons

While Influenza B viruses currently circulating worldwide are of two distinct evolutionary hemagglutinin lineages, current trivalent inactivated influenza virus vaccines (TIV) contain only a single component. Single doses of TIV containing B antigen of B/Florida/4/2006 (Yamagata-like) or B/Brisbane/60/2008 (Victoria-like) were administered during 2008/2009 and 2009/2010 influenza seasons, respectively. The objective of this study was to evaluate the immunological response against different lineages of B antigens in school-aged children. A non-randomized sero-epidemiological study was conducted and the immunogenicity responses based on sero-protection rate and geometric mean titre ratio (GMTR) of hemagglutination inhibition (HI) antibodies were measured before and after immunization as well as post-influenza season. Our results suggested that school-aged children under the age of 9 years receiving TIV vaccination induced and retained higher level of sero-protection rate (66.7% and 69% for the 2008-09 and 2009-10 season, respectively) to the homologous lineage than the heterologous lineage post-vaccination (19.4% and 27.6% for the 2008-09 and 2009-10 season, respectively). The need for the quadrivalent TIV by including both lineages of influenza B viruses is recommended in this study, particularly for children under the age of 9 years.

Invasive <i>Haemophilus influenzae</i>Type b (Hib) Infections in Children in the Pediatric Department of the University Hospital Gabriel Touré(UH-GT)

Introduction: According to Mali’s National Immunization Center, the Haemophilus influenzae b (Hib) vaccine coverage rate was 90% in 2015. Our work aimed to study invasive bacterial infections due to Haemophilus influenzae type b in children aged 0 - 15 years hospitalized in the pediatrics department of the UH-GT. Method: We carried out a retrospective descriptive study from January 2017 to December 2018 (i.e. 2 years) among children aged 0 - 15 years and hospitalized for Haemophilus influenzae type b infection confirmed by culture (blood culture, Cerebro-spinal Fluid, and pleural and skin fluid). Results: Thirty-three cases of Hib infections were collected giving a frequency of 0.2% and the age group 3 months to 3 years was the most affected (72.73%). Children who received no vaccine accounted for 21.21%. The Cerebro-spinal Fluid culture and other samples (pleural and skin) identified the bacterium in 100% of cases, against 72.72% in the blood culture Meningitis was the most frequent pathology (78.79%) and the lethality was high (21.21%). Conclusion: Despite the introduction of the Hib vaccine in the routine immunization program in Mali, Hib infections remain with a high lethality linked to meningitis.

小儿解表口服液治疗流行性感冒(风热犯卫证)多中心随机对照临床研究

目的评价小儿解表口服液治疗流行性感冒(风热犯卫证)的疗效及其安全性。方法采用分层区组随机、阳性药平行对照、多中心临床试验设计。计划纳入300例受试儿童,随机分为治疗组和对照组。治疗组予小儿解表口服液,对照组予磷酸奥司他韦颗粒,疗程5 d。比较两组疾病临床痊愈时间,完全退热时间,加拿大急性呼吸道疾病和流感量表(Canadian Acute Respiratory Illness and Flu Scale,CARIFS)评分,中医证候疗效,单项症状消失率,退热持续时间,并发症、重症及危重症发生率,和安全性指标。结果共纳入临床诊断患儿300例,其中297例进入全分析数据集(Full a⁃nalysis set,FAS),289例进入符合方案数据集(Per protocol set,PPS),297例进入安全性数据集(Safety set,SS)。治疗后,疾病临床痊愈中位时间,组间比较差异均无统计学意义(P>0.05),采用COX回归分析,按0.75的非劣标准,治疗组非劣效于对照组,PPS与FAS分析结论一致;完全退热中位时间,组间比较,FAS/PPS分析差异无统计学意义(P>0.05),采用COX回归分析,按0.75的非劣标准,治疗组非劣效于对照组;流涕消失率治疗组优于对照组,差异有统计学意义(P<0.05);PPS退热持续时间治疗组6(6~12)h,对照组6(6~7.5)h,经Log-rank检验,差异有统计学意义(P<0.05)。CARIFS评分,中医证候疗效,以及并发症、重症及危重症发生率组间比较差异均无统计学意义(P>0.05)。结论小儿解表口服液治疗儿童流行性感冒(风热犯卫证)具有缩短病程作用,疗效非劣于磷酸奥司他韦颗粒,临床应用的安全性较好。

穴位贴敷联合小儿热速清颗粒治疗儿童流行性感冒

目的探讨穴位贴敷联合小儿热速清颗粒治疗儿童流行性感冒的疗效及对血清巨噬细胞迁移抑制因子(MIF)、淀粉样蛋白A(SAA)、高迁移率族蛋白B1(HMGB-1)的影响。方法选择流行性感冒患儿99例,按随机数表法分为对照组、观察1组、观察2组,各33例。对照组静脉滴注帕拉米韦氯化钠注射液,观察1组在对照组基础上口服小儿热速清颗粒,观察2组在观察1组基础上行穴位贴敷。3组均治疗1周。比较治疗1周后3组临床疗效,症状消失时间,治疗前和治疗1周后的血清MIF、SAA、HMGB-1水平及治疗期间的不良反应发生情况。结果治疗1周后,观察2组总有效率(93.94%,31/33)高于观察1组(75.76%,25/33)、对照组(51.52%,17/33)(P<0.05),观察1组高于对照组(P<0.05)。对照组、观察1组、观察2组咽痛消失、发热消失、体温恢复正常、咳嗽消失、鼻卡他/鼻塞消失及流涕消失时间呈逐渐缩短趋势(P<0.05)。治疗1周后,3组血清MIF、SAA、HMGB-1水平与治疗前比较均降低,对照组、观察1组、观察2组血清MIF、SAA、HMGB-1水平呈逐渐降低趋势(P<0.05)。3组治疗期间的不良反应发生率比较,差异无统计学意义(P>0.05)。结论小儿热速清颗粒可有效促进流感患儿相关症状缓解,减轻患儿机体炎症反应,提高治疗效果;小儿热速清颗粒基础上联用穴位贴敷治疗效果更佳,且安全性良好。

蒿芩白虎汤加减治疗小儿流行性感冒的临床研究

目的探究蒿芩白虎汤治疗小儿流行性感冒(流感)的临床疗效。方法选取2019年1月至2021年2月广州市妇女儿童医疗中心3个院区的122例流感患儿作为研究对象,根据治疗方法不同分为治疗组(n=60)与对照组(n=62)。治疗组给予蒿芩白虎汤加减治疗,对照组给予奥司他韦颗粒治疗,比较两组热峰、发热持续时间、症状体征改善情况及治愈率及甲型乙型流感病毒核酸阳性患儿症状、体征改善情况。结果两组热峰比较差异无统计学意义;治疗组发热持续时间短于对照组,差异有统计学意义(P<0.05)。治疗5d后,两组咳嗽、鼻塞或流涕、头痛、咽红或扁桃体红肿、眼结膜充血、腹泻或呕吐发生率均低于治疗前,治疗组咽痛、肌肉酸痛或乏力发生率均低于治疗前,差异有统计学意义(P<0.05),对照组治疗前后咽痛、肌肉酸痛或乏力发生率比较差异无统计学意义。治疗后,治疗组咳嗽生率低于对照组,差异有统计学意义(P<0.05),两组其他症状发生率比较差异无统计学意义。治疗组治愈率为61.7%,高于对照组的40.3%,差异有统计学意义(P<0.05)。两组甲型乙型流感病毒核酸阳性患儿间治疗前后各症状、体征比较差异均无有统计学意义。结论蒿芩白虎汤治疗小儿流感效果确切,可缩短流感患儿发热持续时间,改善患儿临床症状,具有较高的临床应用价值。

新型冠状病毒感染疫情前后儿童流感流行病学调查研究

目的分析新型冠状病毒感染疫情前后儿童流感的流行特征,为流感疫情防控提供科学依据。方法整理2018年1月至2021年12月西安医学院第一附属医院儿科流感病例流行病学资料,分析近年儿童流感感染情况,使用描述性流行病学方法进行统计学分析。结果共上报6881例儿童流感病例,甲型流感共6308例,占91.67%,乙型流感573例,占8.33%,不同年份、不同抗原型流感比较差异有统计学意义(P<0.05);男∶女为1.22∶1.00,性别对于流感感染无影响(P>0.05);流感发病随年龄增加呈现递增趋势,以学龄期(>6~14岁)儿童为主,不同年龄段感染流感比较差异有统计学意义(P<0.05);每年第一、四季度为流感高发季节,新冠前后不同季节发生流感病儿比较差异有统计学意义(P<0.05);流感地区分布差异无统计学意义(P>0.05)。结论新型冠状病毒感染疫情后儿童流感病例明显下降,疫情防控政策也有效的控制了流感流行;每年第一、四季度为流感高发季节,应注重流感季节流感防控及筛查;学龄期(>6~14岁)儿童发病率高,关注此类人群的防护。

2022—2023年上海某医学中心儿童流感流行病学分析

目的分析2022—2023年上海交通大学医学院附属上海儿童医学中心收治的流感患者感染甲型、乙型流感病毒的状况,及时为该地区的流感防控措施的调整提供科学依据。方法分析研究对象甲型、乙型流感病毒抗原、核酸检测阳性情况,明确2022—2023年流感流行情况及优势类型。分别通过抗原检测法和核酸检测法分析2023年甲型流感病毒感染高峰,并比较不同性别、年龄患者甲型流感病毒的两种方法检测的阳性率。结果2022、2023年流感病毒抗原检测阳性患者中,以甲型流感病毒感染患者为主。男性患者与女性患者甲型流感病毒抗原、核酸检测阳性率比较,差异无统计学意义(P>0.05)。不同年龄患者甲型流感病毒抗原、核酸检测阳性率比较,差异有统计学意义(P<0.05);与其他年龄段比较,>5~10岁患者甲型流感病毒抗原、核酸检测阳性率最高。2023年2—12月甲型流感病毒核酸检测阳性率(50.91%)明显高于甲型流感病毒抗原检测阳性率(28.73%),差异有统计学意义(P<0.05)。结论2022年该地区未形成流感病毒感染高峰,2023年有2次甲型流感病毒感染高峰,甲型流感病毒抗原及核酸检测阳性率因检测方法的不同而有所差异。

抗感颗粒联合磷酸奥司他韦颗粒治疗儿童乙型流行性感冒的疗效观察

目的 观察抗感颗粒联合磷酸奥司他韦颗粒治疗儿童乙型流行性感冒(流感)的临床疗效。方法 130例儿童乙型流感患儿,随机分为治疗组和对照组,各65例。治疗组口服抗感颗粒联合磷酸奥司他韦颗粒治疗,对照组口服磷酸奥司他韦颗粒治疗。比较两组患儿治疗效果、退热时间、头痛消失时间、肌肉酸痛乏力消失时间及不良反应发生情况。结果 治疗组退热时间(38.00±8.26)h、头痛消失时间(24.00±5.52)h、肌肉酸痛乏力消失时间(34.00±3.76)h均短于对照组的(46.00±7.32)、(34.00±10.24)、(50.00±7.29)h,比较有显著性差异(P<0.05)。治疗组总有效率92.31%显著高于对照组的78.46%,比较有显著性差异(P<0.05)。两组均无明显药物不良反应发生。结论 抗感颗粒联合磷酸奥司他韦颗粒治疗儿童乙型流感疗效良好,可缩短临床症状缓解时间,值得临床推广使用。

长沙县地区门诊儿童常见上呼吸道感染病原体共感染特征

目的分析长沙县上呼吸道感染病原谱特点,探讨该地区常见呼吸道病原体的共感染分布特征,为该地区呼吸道感染疾病的早期诊断和治疗提供可靠依据。方法回顾性分析湖南省长沙市长沙县妇幼保健院门急诊于2022年1—6月收治的17456例上呼吸道感染患儿(年龄<14岁)的临床资料,患儿均采集咽拭子标本,采用多重聚合酶链反应检测6种常见病原体:甲型流感病毒(Flu.A)、乙型流感病毒(Flu.B)、呼吸道合胞病毒(RSV)、腺病毒(ADV)、鼻病毒(HRV)、肺炎支原体(MP),分析不同性别、年龄患儿病原体检出情况,以及单一感染率与混合感染率等感染分布特征。结果17456例患儿病原体检出率为52.93%,主要感染病原体依次为Flu.B(24.00%)、HRV(11.41%)、Flu.A(8.41%)、RSV(6.54%)、ADV(5.20%)和MP(1.45%),混合感染率为4.02%。男童中MP与Flu.B或ADV混合感染率高于女童,差异有统计学意义(P<0.05)。随着年龄增长,Flu.B及MP检出率明显升高,差异有统计学意义(P<0.05)。MP、ADV感染患儿更易发生混合感染,MP混合感染约占MP总感染的24.11%,MP混合感染患儿白细胞计数异常、中性粒细胞百分比异常、淋巴细胞百分比异常的比例相对MP单一感染患儿更高,差异有统计学意义(P<0.05)。结论该地区儿童常见上呼吸道感染病原体主要为Flu.B、HRV、Flu.A,常见病原体检出率及其混合感染率呈现年龄差异性,MP感染患儿易发生混合感染,及时、准确鉴别呼吸道感染病原体有利于早期诊断和合理用药。

儿童危重症甲型流感病毒感染危险因素的病例对照研究

背景部分危重症甲型流感病毒(IAV)感染患儿可发生严重的后遗症甚至死亡,但其早期的临床表现无特异性,目前国内外缺乏相关预测模型的研究。目的建立儿童危重症IAV感染的列线图预测模型,以帮助临床早期识别危重症IAV感染。设计病例对照研究。方法纳入2018年1月至2023年11月在郑州大学附属儿童医院住院的IAV感染连续病例,根据出院诊断结合临床资料分为危重症和非危重症患儿,截取患儿的人口学资料、入院时症状、入院时实验室检查项目、合并其他病原体感染情况。根据IAV在河南省的发生率计算样本量需>320例,将纳入患儿按7∶3的比例随机分为建模组和验证组,在建模组病例中筛选危重症IAV感染的影响因素,并采用R 4.3.2软件包构建危重症IAV感染的列线图预测模型。主要结局指标儿童危重症IAV感染的影响因素。结果391例IAV感染住院患儿中,危重症134例,其中20例(14.9%)出现后遗症,均为神经系统受损,12例(9.0%)死亡;非危重症患儿均治愈出院;建模组274例,验证组117例,两组临床资料差异均无统计学意义。多因素Logistic回归分析显示,合并其他病原菌感染(OR=3.092,95%CI:1.379~6.934)、出现神经系统症状(OR=6.923,95%CI:2.569~18.656)、中性粒细胞与淋巴细胞比值(NLR)升高(OR=1.404,95%CI:1.029~1.914)和IL-6升高(OR=1.009,95%CI:1.000~1.018)是发生危重症IAV感染的危险因素,白蛋白升高(OR=0.925,95%CI:0.862~0.992)是发生危重症IAV感染的保护因素。以危重症IAV感染为预测结局,以有神经系统症状、合并其他病原体感染以及实验室指标NLR、IL-6、白蛋白,构建列线图预测模型。建模组和验证组AUC分别为0.949(95%CI:0.915~0.982)和0.912(95%CI:0.871~0.952);该列线图模型拟合较好(χ^(2)=5.077,P=0.749),具有较高的临床净获益率。结论基于合并其他病原体感染、神经系统症状以及实验室指标NLR、IL-6、白蛋白构建的列线图预测模型,其有效性和鉴别能力良好。

帕拉米韦氯化钠注射液治疗小儿流行性感冒的临床效果

目的 探讨帕拉米韦氯化钠注射液治疗小儿流行性感冒的临床效果。方法 选取2017年8月至2023年7月临沂市兰山区妇幼保健院治疗的120例流行性感冒患儿作为研究对象,按照随机数字表法分为观察组(60例)与对照组(60例)。观察组采用帕拉米韦氯化钠注射液治疗,对照组采用磷酸奥司他韦颗粒治疗。比较两组症状缓解时间、临床疗效及血清炎症因子水平。结果 观察组各项症状缓解时间均短于对照组(P <0.05);观察组治疗总有效率高于对照组(P <0.05);治疗后,观察组C反应蛋白、白细胞介素-6、肿瘤坏死因子-α水平均低于对照组(P <0.05)。结论 帕拉米韦氯化钠注射液治疗小儿流行性感冒的临床疗效较好,可改善临床症状,值得推广。

小儿豉翘清热颗粒联合奥司他韦治疗儿童甲型H1N1流感的效果及对免疫功能的影响

目的:观察小儿豉翘清热颗粒联合奥司他韦治疗儿童甲型H1N1流感的效果及对免疫功能的影响。方法:选择2021年1月—2023年1月于宿迁市第一人民医院就诊的102例甲型H1N1流感患儿作为研究对象,采用随机数表法将其分为常规组(n=51)与中药组(n=51)。两组均给予一般治疗与护理,常规组给予口服磷酸奥司他韦治疗,中药组在常规组基础上给予小儿豉翘清热颗粒口服治疗。比较两组临床疗效、中医症候积分、T淋巴细胞亚群水平与不良反应。结果:中药组治疗总有效率为96.08%,高于常规组的82.35%,差异有统计学意义(P<0.05);治疗后,两组主症、次症积分较治疗前降低,且中药组低于常规组,差异有统计学意义(P<0.05);治疗后,两组CD3^(+)、CD4^(+)与CD4^(+)/CD8^(+)较治疗前升高,且中药组高于常规组,CD8^(+)较治疗前降低,且中药组低于常规组,差异有统计学意义(P<0.05);中药组不良反应发生率为7.84%,高于常规组的3.92%,但差异无统计学意义(P>0.05)。结论:小儿豉翘清热颗粒与奥司他韦联合使用可以有效治疗儿童甲型H1N1流感,缓解临床症状,提高免疫功能,且安全性较高。

小儿豉翘清热颗粒联合磷酸奥司他韦治疗小儿流行性感冒临床研究

目的探讨小儿豉翘清热颗粒联合磷酸奥司他韦治疗小儿流行性感冒的临床效果。方法选择盐城市亭湖区人民医院2022年1月-2023年10月收治的流行性感冒患儿82例,按随机数表法分为对照组与观察组,每组41例。对照组采用磷酸奥司他韦治疗,观察组采用小儿豉翘清热颗粒联合磷酸奥司他韦治疗。比较两组临床效果、症状改善时间、炎性因子水平及不良反应。结果观察组治疗总有效率较对照组更高,差异有统计学意义(P<0.05)。相比对照组,观察组各症状缓解时间更短,差异有统计学意义(P<0.05)。治疗后,两组CRP、TNF-α及IL-6水平均下降,且观察组各炎性因子水平均更低,差异有统计学意义(P<0.05)。两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论采用小儿豉翘清热颗粒联合磷酸奥司他韦治疗流行性感冒患儿可加速其症状缓解,减轻炎性反应,且不增加不良反应。

乌鲁木齐米东区社区获得性病毒性肺炎患儿的病原体检测与流行病学情况分析

目的探讨与分析乌鲁木齐米东区社区获得性病毒性肺炎患儿的病原体检出与流行病学情况,希望为预防社区获得性病毒性肺炎的发生提供参考。方法选择2023年3月—2023年5月在乌鲁木齐米东区人民医院诊治的90例社区获得性病毒性肺炎患儿作为本次课题研究的对象,采集所有患儿的鼻咽拭子,采用多病原核酸检测技术检测病原体状况。结果在90例患儿中,检出流感病毒A型阳性6例、流感病毒B型22例、副流感病毒1型2例、副流感病毒2型1例、鼻病毒25例、呼吸道合胞病毒15例、腺病毒10例、人类偏肺病毒3例、博卡病毒6例。检出混合感染9例,占比10.0%,其中2种病毒混合感染7例,3种病毒混合感染2例。不同性别人群的多病原核酸检测分布情况对比,差异无统计学意义(P>0.05);<1岁人群的鼻病毒、流感病毒B型检出率显著高于其他年龄段人群(P<0.05);冬季人群的流感病毒B型检出率显著高于其他季节,其他病毒在不同季节与年龄人群的分布情况对比,差异无统计学意义(P>0.05)。结论乌鲁木齐米东区社区获得性病毒性肺炎患儿的病原体以鼻病毒、流感病毒B型、呼吸道合胞病毒、腺病毒为主,可表现为混合感染,年龄、季节与鼻病毒、流感病毒B型感染的发生密切相关。

奥司他韦对甲型与乙型流感患儿症状改善及不良反应的影响

目的探讨奥司他韦对甲型与乙型流行性感冒患儿症状改善及不良反应影响。方法回顾性选取2020年6月—2022年9月中山大学孙逸仙纪念医院收治的甲、乙型流感患儿81例,根据抗原检测结果分为甲型流感组(47例)与乙型流感组(34例)。两组患儿均采用磷酸奥司他韦治疗,对比观察两组患儿的症状改善时间、临床疗效以及不良反应发生情况。结果甲型流感组患儿高热、咳嗽、鼻塞流涕、全身症状改善时间分别为(1.62±0.53)d、(3.20±0.75)d、(4.08±1.24)d、(4.10±1.26)d,乙型流感组患儿分别为(3.47±0.78)d、(4.61±1.35)d、(5.11±1.27)d、(5.56±1.50)d,甲型流感组症状改善时间均短于乙型流感组(均P<0.05)。甲型流感组治疗有效率(95.74%,45/47)高于乙型流感组(82.35%,28/34)(P<0.05),甲型流感组不良反应发生率与乙型流感组比较差异无统计学意义[10.63%(5/47),11.67%(4/34),P>0.05]。结论奥司他韦对甲型与乙型流感患儿治疗均有效,不良反应发生情况较少。奥司他韦治疗甲型流感患儿的效果以及症状改善情况均优于乙型流感患者。

2019—2020年中国9472例流行性感冒确诊患儿中医证候横断面调查

[目的]儿童流行性感冒迄今为止尚无规范的中医分型,通过调查2019—2020年冬春季中国儿童流行性感冒中医证候分布规律,为临床精准辨证施治提供参考。[方法]在文献研究及德尔菲法专家问卷的基础上,制定“儿童流行性感冒中医证候调查问卷”,采用分层简单随机抽样的横断面调查方法,对全国6大行政区域18家三甲医院进行问卷调查,分析总结不同年龄、不同流感类型、不同区域患儿中医证型分布特点及各证型患儿症状特点。[结果]9472例患儿中,1)风热犯卫证占46.63%,表寒里热证23.41%,毒热内陷证11.07%,风寒束表证8.12%,邪犯肺胃证5.87%,热毒袭肺证4.88%,正虚邪恋证0.02%。2)超高热占4.30%,高热44.52%,中度发热44.37%,低热6.79%。3)甲型流感占90.51%,乙型流感9.49%,均以风热犯卫证为主(分别占46.44%、48.50%)。4)在发热的不同病程阶段,均以风热犯卫证、表寒里热证为多见,随着发热时间的推移风寒束表证比例逐渐下降,热毒袭肺证比例逐渐上升。5)各年龄段均以风热犯卫证、表寒里热证多见,各区域中医证候均以风热犯卫证为主。[结论]2019—2020年中国儿童流行性感冒以甲型流感为主,中医证型以风热犯卫证、表寒里热证为主;发热为各证型的核心症状,毒热内陷证以高热及超高热为主,其他证型以中高度热为主;不同年龄、不同类型及不同区域中医证型分布均以风热犯卫证为主。