儿童腺病毒引起的下呼吸道感染。闭塞性细支气管炎和死亡的临床特征及危险因素。

Lower respiratory infections by adenovirus in children. Clinical features and risk factors for bronchiolitis obliterans and mortality.

作者信息

Murtagh Patricia, Giubergia Verónica, Viale Diana, Bauer Gabriela, Pena Hebe Gonzalez

机构信息

Pediatric Pulmonology Department, Hospital de Pediatria Juan P. Garrahan, Buenos Aires, Argentina.

出版信息

Pediatr Pulmonol. 2009 May;44(5):450-6. doi: 10.1002/ppul.20984.

DOI:10.1002/ppul.20984

PMID:19360848

Abstract

UNLABELLED

Adenovirus (Ad) respiratory infections have a profound impact in Argentina. Severe chronic disease and a high mortality rate are observed in children after acute lower respiratory infections (ALRI) by Ad.

METHODS

A retrospective observational study was performed to describe clinical characteristics and to analyze risk factors for bronchiolitis obliterans (BO) and death in 415 children hospitalized with ALRI caused by Ad from March 1988 to May 2005.

RESULTS

Mean age of patients was 10.7 months (+/-9.2) Overall 80% of patients were healthy before ALRI. Forty-nine percent recovered, sequelae were observed in 36% and 15% died. Independent risk factors for BO were: >30 days of hospitalization (odds ratio (OR) 27.2, 95% confidence interval (CI) 14.6-50.9), multifocal pneumonia (OR 26.6, 95% CI 5.3-132) and hypercapnia (OR 5.6, 95% CI 3.5-9). Independent risk factors for death in acute stage of disease were: mechanical assistance (OR 121, 95% CI 18.2-814), multifocal pneumonia (OR 102, 95% CI 9.5-31.1), hypercapnia (OR 42.6, 95% CI 10.2-177.1), coagulation disorders (OR 17, 95% CI 8.25-35), neurological symptoms (OR 12.7, 95% CI 3.5-6.6) and co-infection with measles (OR 9.6, 95% CI 2.1-44.2).

CONCLUSIONS

High incidence of sequelae and mortality in previously healthy children after Ad infection was observed in a population of children from Argentina.

摘要

未标记

腺病毒（Ad）呼吸道感染在阿根廷产生了深远影响。在儿童急性下呼吸道感染（ALRI）后由Ad引起的严重慢性疾病和高死亡率被观察到。

方法

进行了一项回顾性观察研究，以描述415例在1988年3月至2005年5月因Ad引起的ALRI住院儿童的临床特征，并分析闭塞性细支气管炎（BO）和死亡的危险因素。

结果

患者的平均年龄为10.7个月（±9.2）。总体而言，80%的患者在ALRI之前是健康的。49%康复，36%观察到后遗症，15%死亡。BO的独立危险因素为：住院超过30天（比值比（OR）27.2，95%置信区间（CI）14.6 - 50.9）、多灶性肺炎（OR 26.6，95%CI 5.3 - 132）和高碳酸血症（OR 5.6，95%CI 3.5 - 9）。疾病急性期死亡的独立危险因素为：机械辅助（OR 121，95%CI 18.2 - 814）、多灶性肺炎（OR 102，95%CI 9.5 - 31.1）、高碳酸血症（OR 42.6，95%CI 10.2 - 177.1）、凝血障碍（OR 17，95%CI 8.25 - 35）、神经症状（OR 12.7，95%CI 3.5 - 6.6）和麻疹合并感染（OR 9.6，95%CI 2.1 - 44.2）。