摘要
目的分析鲁西南地区儿童呼吸道合胞病毒(RSV)肺炎的临床特征,探讨发生重症RSV肺炎的相关因素。方法回顾性分析2021年10月至2022年9月济宁医学院附属医院儿科收治的252例RSV肺炎患者的临床资料。根据病情严重程度分为轻症肺炎组(n=168)及重症肺炎组(n=84),对两组临床资料进行比较,运用多因素Logistic回归分析发生重症RSV肺炎的危险因素。结果男童156例(61.90%),女童96例(38.10%),男女比1.63∶1。RSV感染率较高的3个年龄组分别为年龄≤3个月(60.32%,152/252)、3~6个月(21.83%,55/252)、6月~1岁(7.94%,20/252)。接触呼吸道感染人群(看护人/共同居住者患呼吸道感染)后发病患者146例(57.94%);有基础疾病患者38例(15.08%)。重症RSV肺炎组与轻症RSV肺炎组在贫血(19.05%,10.12%)、发热(55.95%,29.76%)、喘息(57.14%,39.88%)、有基础疾病(28.57%,8.33%)方面比较,均差异有统计学意义(χ^(2)=3.92,16.23,6.73,17.91;均P<0.05)。重症RSV肺炎组患者住院时间更长[(8.86±3.71)d,(7.67±1.95)d],治疗上需要氧疗(65.48%,14.29%)、静注人免疫球蛋白(38.10%,5.95%)、糖皮质激素(38.10%,25.00%)比例明显增高,差异有统计学意义(t=3.32,χ^(2)=68.19,41.66,4.63;均P<0.05)。重症RSV肺炎组患者白细胞数[(8.66±3.58)×10^(9)/L]、C反应蛋白[1.16(0.25,12.19)mg/L]、乳酸脱氢酶[(353.09±113.89)U/L]、α-羟丁酸脱氢酶[(272.80±89.65)U/L]较轻症RSV肺炎组[(7.86±2.40)×10^(9)/L,0.57(0.26,2.35)mg/L,(288.29±73.13)U/L,(223.02±49.39)U/L]增高,差异有统计学意义(t=2.09,Z=2.22,t=5.40,5.60;均P<0.05)。将单因素分析显示有统计学意义的变量进行多因素Logistic分析,结果显示发热、喘息、存在基础疾病、乳酸脱氢酶水平升高是发生重症RSV肺炎的独立危险因素(OR=18.019,2.564,4.275,2.348;均P<0.05)。结论RSV肺炎可发生在所有年龄组儿童,尤其是1岁以下婴儿多见。存在基础疾病、发热、喘息、乳酸脱氢酶升高是发展成重症RSV肺炎的�
Objective To analyze the clinical characteristics of respiratory syncytial virus(RSV)pneumonia in children in Southwest Shandong,and explore the factors associated with severe RSV pneumonia occurrence.Methods Retrospective analysis was conducted on the clinical data of 252 cases of RSV pneumonia admitted to the Department of Pediatrics at Affiliated Hospital of Jining Medical University from October 2021 to September 2022.According to the severity of the condition,the cases were categorized into mild pneumonia group(n=168)and severe pneumonia group(n=84).A comparative analysis of the clinical data of the 2 groups was performed,and a multivariate Logistic regression analysis was used to identify the risk factors associated with the occurrence of severe RSV pneumonia.Results The study included 252 cases of RSV pneumonia,with 156 boys(61.90%)and 96 girls(38.10%),resulting in a male-to-female ratio of 1.63∶1.The 3 age groups with the highest RSV infection rates were aged≤3 months(60.32%,152/252),3-6 months(21.83%,55/252),and 6 months to 1 year(7.94%,20/252).Of the total,146 patients(57.94%)had a history of contact with respiratory infectious diseases became ill after exposure to respiratory infections(caregivers or co-residents underwent respiratory infections),38 patients(15.08%)had underlying diseases.The differences between the severe RSV pneumonia group and the mild RSV pneumonia group were statistically significant in terms of anemia(19.05%,10.12%),fever(55.95%,29.76%),wheezing(57.14%,39.88%),and having underlying disease(28.57%,8.33%)(χ^(2)=3.92,16.23,6.73,17.91,all P<0.05).Patients in the severe RSV pneumonia group had a longer hospital stay[(8.86±3.71)d,(7.67±1.95)d],and a higher proportion of requiring oxygen therapy(65.48%,14.29%),intravenous immunoglobulin therapy(38.10%,5.95%),and glucocorticoid therapy(38.10%,25.00%)compared to the mild RSV group.These differences were statistically significant(t=3.32,χ^(2)=68.19,41.66,4.63,all P<0.05).Compared to the mild RSV group,the severe RSV pneumonia group
作者
吴敬芳
谭清实
郗夏颖
樊节敏
韩蕾
辛美云
Wu Jingfang;Tan Qingshi;Xi Xiaying;Fan Jiemin;Han Lei;Xin Meiyun(Department of Pediatrics,Affiliated Hospital of Jining Medical University,Jining 272029,China;Department of Emergency,Affiliated Hospital of Jining Medical University,Jining 272029,China)
出处
《中华诊断学电子杂志》
2024年第1期44-49,共6页
Chinese Journal of Diagnostics(Electronic Edition)
基金
济宁市重点研发计划项目(2022YXNS181)。
关键词
儿童
呼吸道合胞病毒
重症肺炎
危险因素
Child
Respiratory syncytial virus
Severe pneumonia
Risk factor
