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分析儿童因严重流感导致死亡的临床特征和危险因素。

Analysis of clinical characteristics and risk factors for death due to severe influenza in children.

机构信息

Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children's Hospital Affiliated to Zhengzhou University, No. 1, South University Road, Erqi District, Zhengzhou, 450052, Henan, China.

出版信息

Eur J Clin Microbiol Infect Dis. 2024 Mar;43(3):567-575. doi: 10.1007/s10096-024-04759-1. Epub 2024 Jan 19.

Abstract

OBJECTIVE

The study analyzed the clinical features of children who had severe influenza and discussed on the risk factors associated with death in this population.

METHODS

A total of 167 children with severe influenza admitted to the intensive care unit of our hospital from January 2018 to August 2023 were selected and divided into the death group (27 cases) and the survival group (140 cases). Demographic characteristics and clinical data were collected and compared between the two groups. Logistic regression analysis was used to explore the risk factors for death in children with severe influenza.

RESULTS

The male-to-female ratio of the 167 children with severe influenza was 2.21:1, the median age was 3 years, and influenza A accounted for 70.66%. The CD4 T cells percentage and CD4/CD8 were lower in the death group; the percentage of comorbid underlying diseases, mechanical ventilation, other systemic involvement, comorbid associated encephalopathy or encephalitis, and red blood cell distribution width (RDW), lactate dehydrogenase, activated partial thromboplastin time (APTT), and interleukin 6 were higher in the death group. The mechanical ventilation, associated encephalopathy or encephalitis, RDW, APTT, and CD4/CD8 were the independent risk factors for death.

CONCLUSION

Mechanical ventilation, comorbid encephalopathy or encephalitis, increased RDW, prolonged APTT, and decreased CD4/CD8 are independent risk factors for death in children with severe influenza.

摘要

目的

本研究分析了儿童重症流感的临床特征,并探讨了该人群死亡相关的危险因素。

方法

选取我院重症监护病房 2018 年 1 月至 2023 年 8 月收治的 167 例重症流感患儿,分为死亡组(27 例)和存活组(140 例)。收集并比较两组患儿的人口统计学特征和临床资料。采用 logistic 回归分析探讨儿童重症流感死亡的危险因素。

结果

167 例重症流感患儿中,男女性别比为 2.21:1,中位年龄为 3 岁,甲型流感占 70.66%。死亡组患儿 CD4+T 细胞百分比和 CD4/CD8 较低;合并基础疾病、机械通气、其他系统受累、合并相关脑病或脑炎、红细胞分布宽度(RDW)、乳酸脱氢酶(LDH)、活化部分凝血活酶时间(APTT)、白细胞介素 6(IL-6)水平较高。机械通气、相关脑病或脑炎、RDW、APTT、CD4/CD8 是死亡的独立危险因素。

结论

机械通气、合并脑病或脑炎、RDW 增加、APTT 延长、CD4/CD8 降低是儿童重症流感死亡的独立危险因素。

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