摘要
目的 归纳总结深圳市儿童医院住院患儿人副流感病毒(HPIV)感染的临床特点,为预防及诊治HPIV感染提供参考。方法 收集2019-09-01-2021-08-31在深圳市儿童医院住院且诊断为HPIV感染患儿的临床资料,回顾性分析HPIV感染的季节、年龄、基础疾病、混合感染情况和临床表现等特点。统计HPIV检出情况、季节分布、年龄分布和临床特征。结果 共检出HPIV阳性患儿627例,阳性率为3.29%,男性和女性检出率比较,差异无统计学意义,P>0.05。HPIV检出率2019年秋季为1.55%,冬季为1.37%,2020年春季为0,夏季为0.37%,秋冬季高于春夏季,差异有统计学意义,χ^(2)=23.383,P<0.001;2020年秋季为5.87%,冬季为6.06%,2021年春季为4.19%,夏季为1.94%,秋冬季高于春夏季,差异有统计学意义,χ^(2)=87.760,P<0.001。0~1岁212例(33.81%),>1~3岁215例(34.29%),>3~5岁154例(24.56%),>5~18岁46例(7.34%),平均发病年龄25.54个月。感染患儿中,单纯呼吸道表现221例,肺外表现406例,肺外表现与单纯呼吸道表现患儿在年龄<60个月(χ^(2)=12.008,P=0.007)、血小板增多(χ^(2)=10.666,P=0.001)和中性粒细胞减少(χ^(2)=72.184,P<0.001)方面比较,差异有统计学意义。混合感染343例,单一感染284例,单一感染与混合感染患儿在发热(χ^(2)=5.362,P=0.021)、咳嗽(χ^(2)=11.566,P=0.001)和中性粒细胞减少(χ^(2)=16.799,P<0.001)方面比较,差异有统计学意义。113例有基础疾病,514例无基础疾病,有无基础疾病患儿在年龄<60个月(χ^(2)=9.122,P=0.028)、气促(χ^(2)=9.488,P=0.002)、发绀(χ^(2)=14.833,P<0.001)、重症HPIV感染(χ^(2)=23.562,P<0.001)方面比较,差异有统计学意义。HPIV感染导致非呼吸系统疾病165例(26.32%)。结论 HPIV是深圳市儿童医院住院患儿病毒感染的重要病原,秋冬季高发,婴幼儿多见,混合感染较常见,常伴有基础疾病,多数有肺外表现,可引起多系统、多脏器损伤。
Objective To summarize the clinical characteristics of human parainfluenza virus(HPIV)infection in hospitalized children in Shenzhen Children's Hospital,and provide reference for the prevention and treatment of HPIV infection.Methods The clinical data of children hospitalized in Shenzhen Children's Hospital from September 1,2019 to August 31,2021and diagnosed with HPIV infection were collected,and the characteristics of HPIV infection season,age,basic disease,mixed infection and clinical manifestation were analyzed retrospectively.The detection,seasonal distribution,age distribution and clinical characteristics of HPIV were analyzed.Results A total of 627 children with HPIV positive were detected,with a positive rate of 3.29%.There was no significant difference between the detection rates of men and women(P<0.05).The detection rate of HPIV in 2019 was 1.55%in autumn,1.37% in winter,in 2020,0 in spring and 0.37%in summer,the detection rate in autumn and winter was higher than that in spring and summer,with a statistically significant difference,χ^(2)=23.383,P<0.001.In 2020,it was 5.87% in autumn,6.06%in winter,in 2021,4.19% in spring and 1.94%in summer,the detection rate in autumn and winter was higher than that in spring and summer,with a statistically significant difference,χ^(2)=87.760,P<0.001.Totally 212cases(33.81%)aged 0-1years,215cases(34.29%)aged1-3years,154cases(24.56%)aged3-5years,46cases(7.34%)aged5-18years,with an average age of 25.54months.Among the infected children,221cases had simple respiratory manifestations and406cases had extrapulmonary manifestations.Children with extrapulmonary manifestations compared with simple respiratory manifestations,the difference was statistically significant among aged60 months(χ^(2)=12.008,P=0.007),thrombocytosis(χ^(2)=10.666,P=0.001)and neutropenia(χ^(2)=72.184,P<0.001).There were 343cases of mixed infection and 284cases of single infection.Children with mixed infection compared withsingle infection,the difference was statistically significant among fever(χ^(2)=5.362,P=0.021),cough(χ^(2)=11.566,P=0.001)and neutropeniab(χ^(2)=16.799,P<0.001).There were 113cases had basic diseases and 514cases had no basic diseases.Compared with children with and without basic diseases,the difference was statistically significant among aged60months(χ^(2)=9.122,P=0.028),shortness of breath(χ^(2)=9.488,P=0.002),cyanosis(χ^(2)=14.833,P<0.001)and severe HPIV infection(χ^(2)=23.562,P<0.001).There were 165cases(26.32%)of non-respiratory diseases were caused by HPIV infection.Conclusions HPIV is an important pathogen of viral infection in hospitalized children in Shenzhen Children's Hospital.It is high in autumn and winter,and frequently in infants and young children.Mixed infection is common,often accompanied by basic diseases.Most of them have extrapulmonary manifestations,which can cause multi-system and multi-organ injuries.
作者
张安全
王红梅
邓继岿
ZHANG Anquan;WANG Hongmei;DENG Jikui(Shenzhen Clinical College of Pediatrics,Shantou University Medical College,Shenzhen 518034,China;Department of Infection,The Children's Hospital of Shenzhen,Shenzhen 518034,China)
出处
《社区医学杂志》
CAS
2023年第7期329-333,339,共6页
Journal Of Community Medicine
基金
广东省高水平临床重点专科(深圳市配套建设经费)资助项目(SZGSP012)。
关键词
人副流感病毒
儿童
病毒感染
肺外表现
混合感染
human parainfluenza virus
children
viral infection
extrapulmonary manifestations
mixed infection
