摘要
目的总结重症乙型流感病毒肺炎患者的临床特点,分析预后相关危险因素。方法纳入2020年2月—至2022年2月因乙型流感病毒肺炎入住重症监护病房(intensive care unit,ICU)的患者,根据预后分为存活组和死亡组,对比两组人口学资料及化验检查差异,采用二元单因素logistic回归分析死亡相关危险因素。并与重症甲型流感病毒肺炎患者相对比,总结乙型流感病毒肺炎患者特点。结果本研究共纳入23例重症乙型流感病毒肺炎患者,其中男10例,女13例,存活组18例,死亡组5例。死亡组患者中位年龄64(64,72.5)岁,显著高于存活组59(30.25,64.25)岁(P=0.030)。单因素logistic回归分析显示,SOFA评分[比值比(odds ratio,OR)1.307,95%置信区间(confidential interval,CI)1.013~1.686,P=0.039]、血红蛋白(OR 0.845,95%CI0.715~0.997,P=0.046)、以及尿素氮(OR 1.432,95%CI 1.044~1.963,P=0.026)为重症乙型流感病毒肺炎患者ICU住院期间死亡的独立危险因素。与甲型流感病毒肺炎相比,重症乙型流感病毒肺炎患者并发症更多(60.0%比87.0%,P=0.023)。结论重症乙型流感病毒肺炎患者死亡率高,SOFA评分高、贫血、尿素氮升高是其ICU住院相关死亡的危险因素。
Objective To identify the clinical features and risk factors for mortality associated with severe influenza B pneumonia of adults admitted to respiratory intensive care unit(ICU).Methods Patients with confirmed influenza B infection and respiratory failure between February 2020 and February 2022 who were admitted to the ICU were sequentially included.Demographic features,clinical data,microbiological data,complications,and outcomes were collected.Univariate logistic regression analysis was performed to identify risk factors associated with hospital mortality.A comparison with severe influenza A pneumonia was made to explore the characteristics of influenza B virus-associated pneumonia.Results A total of 23 patients with influenza B pneumonia were included.The survival group included 18 patients and the death group included 5 patients,with an ICU mortality of 21.7%.The median age in the death group was 64(64,72.5)years,which was significantly older than the survival group,with a median age 59(30.25,64.25)years(P=0.030).Univariate logistic regression analysis indicated that SOFA score[odds ratio(OR)1.307,95%confidential interval(CI)1.013-1.686,P=0.039],decreased hemoglobin(OR 0.845,95%CI 0.715-0.997,P=0.046),and high blood urea nitrogen(BUN)(OR 1.432,95%CI 1.044-1.963,P=0.026)were independent risk factors for hospital mortality.Compared with influenza A pneumonia,patients with severe influenza B pneumonia had more complications(60.0%vs.87.0%,P=0.023).Conclusions The mortality of severe influenza B virus-associated pneumonia with was high.Increased SOFA score,anemia,and high BUN were risk factors for ICU mortality of severe influenza B infection in adults.
作者
张冬梅
高丽娟
唐晓
张佳莹
李绪言
王睿
刘光云
梁连春
童朝晖
孙兵
ZHANG Dongmei;GAO Lijuan;TANG Xiao;ZHANG Jiaying;LI Xuyan;WANG Rui;LIU Guangyun;LIANG Lianchun;TONG Zhaohui;SUN Bing(Department of Respiratory and Critical Care Medicine,Beijing Chaoyang Hospital,Capital Medical University,Beijing Institute of Respiratory Medicine,(Beijing Chaoyang Hospital),Beijing 100020,P.R.China;Beijing Youan Hospital,Capital Medical University,Beijing Institute of Hepatology,Beijing 100069,P.R.China)
出处
《中国呼吸与危重监护杂志》
CAS
CSCD
北大核心
2023年第8期552-558,共7页
Chinese Journal of Respiratory and Critical Care Medicine
基金
北京市医院管理中心临床技术创新项目(XMLX202105)
北京市科学技术委员首都临床诊疗技术研究及转化应用(Z201100005520030)。
