ISSN 1674-3865  CN 21-1569/R
主管:国家卫生健康委员会
主办:中国医师协会
   辽宁省基础医学研究所
   辽宁中医药大学附属医院

中国中西医结合儿科学 ›› 2021, Vol. 13 ›› Issue (6): 507-510.

• 临床研究 • 上一篇    下一篇

儿童流行性感冒并发肺炎的危险因素分析

  

  • 出版日期:2021-12-25 上线日期:2023-12-05

Analysis of risk factors of influenza complicated with pneumonia in children

  • Published:2021-12-25 Online:2023-12-05

摘要: 目的探讨儿童流行性感冒并发肺炎的相关危险因素,以便能对其进行早期的识别及采取正确的处理。方法回顾性分析2016年4月至2019年3月在广州医科大学附属市八医院住院治疗的儿童流行性感冒病例446例,根据其有无并发肺炎分为肺炎组212例和非肺炎组234例。通过查阅研究病例的相关临床诊疗资料采集研究信息,包括性别、年龄、发热情况、既往有无喘息病史、胸部影像学检查、血常规、超敏C反应蛋白(hsCRP)、降钙素原(PCT)、心肌酶谱及治疗用药情况等。对两组临床资料进行单因素比较,再将其中有统计学意义的因素纳入到多因素Logistic回归分析。结果两组临床资料单因素比较发现,两组年龄<3岁、发热>4 d、WBC<3×109/L、hsCRP>20 mg/L、PCT>2μg/L及起病48 h后应用奥司他韦等6项因素比较差异有统计学意义(P<0.05)。进一步多因素Logistic回归分析结果提示,年龄<3岁、hsCRP>20 mg/L及起病48 h后应用奥司他韦3项为儿童流感并发肺炎的独立危险因素。结论儿童确诊流感且CRP>20 mg/L者,如治疗效果不理想时需及时完善胸片排查有无合并肺炎,3岁以下流感儿童应尽可能在发病48 h内应用奥司他韦,对减少肺炎等并发症及改善预后有重要的意义。 

关键词: 流行性感冒, 肺炎, 危险因素, 儿童

Abstract: ObjectiveTo explore the related risk factors of influenza complicated with pneumonia in children, in order to achieve early identification and perform  correct treatment.MethodsA total of 446 cases of influenza in children hospitalized in Guangzhou Eighth People′s Hospital from April 2016 to March 2019 were retrospectively analyzed. They were divided into pneumonia group(n=212) and non-pneumonia group(n=234) according to whether they were complicated with pneumonia or not. Through consulting the relevant clinical data of the studied cases the research information was collected, including gender, age, fever, history of wheezing, chest imaging, blood routine, hsCRP, PCT, myocardial enzyme spectrum and medication. The factors which had statistical significance according to single-factor comparison were included in the multivariate Logistic regression analysis.ResultsThe single factor comparison of clinical data between the two groups showed that there were significant differences in age<3 years old, fever>4 days, WBC<3×109/L, hsCRP>20 mg/L, PCT>2 μg/L and application of oseltamivir 48 hours after onset(P<0.05).Further multivariate Logistic regression analysis showed that age<3 years old, hsCRP>20 mg/L and application of oseltamivir 48 hours after onset were independent risk factors of influenza complicated with pneumonia in children.ConclusionFor children with influenza with CRP>20 mg/L who have poor response to treatment,chest X-ray should be taken in time to exclude pneumonia. The children under 3 years should be given oseltamivir within 48 hours of onset, which is of great significance in reducing pneumonia and improving prognosis.

Key words:

Influenza, Pneumonia, Risk factors, Children