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甲型或乙型季节性流感住院患者肺炎的发病率及危险因素

Incidence and Risk Factors of Pneumonia in Hospitalized Patients with Seasonal Influenza A or B.

作者信息

Chu Seongjun, Park Sang Joon, Koo So My, Kim Yang Ki, Kim Ki Up, Uh Soo Taek, Kim Tae Hyung, Park Suyeon

机构信息

Division of Pulmonary and Allergy Medicine, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.

Division of Infectious Disease, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.

出版信息

Tuberc Respir Dis (Seoul). 2017 Oct;80(4):392-400. doi: 10.4046/trd.2016.0015. Epub 2017 Sep 1.

Abstract

BACKGROUND

Most patients with influenza recover spontaneously or following treatment with an anti-viral agent, but some patients experience pneumonia requiring hospitalization. We conducted a retrospective review to determine the incidence and risk factors of pneumonia in hospitalized patients with influenza A or B.

METHODS

A total of 213 patients aged 18 years or older and hospitalized with influenza between January 2012 and January 2015 were included in this study. A reverse-transcriptase polymerase chain reaction assay was used to detect the influenza A or B virus in the patients' sputum samples. We collected demographic and laboratory data, combined coexisting diseases, and radiologic findings.

RESULTS

The incidence of pneumonia was higher in patients in the influenza A group compared to those in the influenza B group (68.6% vs. 56.9%), but this difference was not statistically significant. The presence of underlying respiratory disease was significantly associated with pneumonia in the influenza A group (adjusted odds ratio [OR], 3.975; 95% confidence interval [CI], 1.312-12.043; p=0.015). In the influenza B group, the white blood cell count (adjusted OR, 1.413; 95% CI, 1.053-1.896; p=0.021), platelet count (adjusted OR, 0.988; 95% CI, 0.978-0.999; p=0.027), and existence of an underlying medical disease (adjusted OR, 15.858; 95% CI, 1.757-143.088; p=0.014) were all significantly associated with pneumonia in multivariate analyses.

CONCLUSION

The incidence of pneumonia was 65.7% in hospitalized patients with influenza A or B. The risk factors of pneumonia differed in hospitalized patients with influenza A or B.

摘要

背景

大多数流感患者可自行康复或在接受抗病毒药物治疗后康复,但部分患者会出现需要住院治疗的肺炎。我们进行了一项回顾性研究,以确定甲型或乙型流感住院患者肺炎的发病率及危险因素。

方法

本研究纳入了2012年1月至2015年1月期间18岁及以上因流感住院的213例患者。采用逆转录聚合酶链反应检测患者痰液样本中的甲型或乙型流感病毒。我们收集了人口统计学和实验室数据、合并的共存疾病以及影像学检查结果。

结果

甲型流感组患者的肺炎发病率高于乙型流感组(68.6%对56.9%),但差异无统计学意义。在甲型流感组中,存在基础呼吸系统疾病与肺炎显著相关(校正比值比[OR]为3.975;95%置信区间[CI]为1.312 - 12.043;p = 0.015)。在乙型流感组中,白细胞计数(校正OR为1.413;95% CI为1.053 - 1.896;p = 0.021)、血小板计数(校正OR为0.988;95% CI为0.978 - 0.999;p = 0.027)以及存在基础内科疾病(校正OR为15.858;95% CI为1.757 - 143.088;p = 0.014)在多因素分析中均与肺炎显著相关。

结论

甲型或乙型流感住院患者的肺炎发病率为65.7%。甲型或乙型流感住院患者肺炎的危险因素有所不同。

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