儿童人博卡病毒所致重症肺炎的临床特征及危险因素

Clinical characteristics and risk factors of severe pneumonia caused by human bocavirus in children.

作者信息

Li Zhuxia, Gu Wenjing, Zhu Fengming, Han Enze, Yan Yongdong, Sun Huiquan, Xu Weidong, Zhang Xin, Huang Li, Gao Shan, Wang Yuqing, Hao Chuangli, Zhang Xinxing

机构信息

Department of Respiratory Medicine, Children's Hospital of Soochow University, Jingde Road No. 303, Suzhou, 215003, China.

Department of pediatrics, Zhangjiagang Hospital affiliated to Soochow University, Jiyang West Road No.68, Suzhou, 215600, China.

出版信息

BMC Infect Dis. 2025 Jan 13;25(1):58. doi: 10.1186/s12879-025-10465-w.

DOI:10.1186/s12879-025-10465-w

PMID:39806307

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11727428/

Abstract

BACKGROUND

The aim of this study was to investigate the clinical characteristics of severe pneumonia caused by human bocavirus (HBoV) infection to explore the associated risk factors.

METHODS

We conducted a retrospective review of data from children hospitalized with HBoV pneumonia. Based on the severity of pneumonia, patients were categorized into severe pneumonia and non-severe pneumonia groups. Clinical manifestations, laboratory examination results, chest imaging and pathogens were analyzed. Logistic regression was employed to identify the risk factors for severe HBoV pneumonia.

RESULTS

A total of 334 patients were admitted, with 44 (13.17%) patients diagnosed with severe pneumonia and 290 (86.83%) with non-severe pneumonia. There were no significant differences in age distribution, presence of fever, lung moist rales, pleural effusion and reduced breath sounds between the two groups (all P > 0.05). 57.19% of the HBoV-positive children co-infected with other pathogens and HRV was the most common co-infected pathogens with HBoV. No significant differences were observed in the rate of co-infection between the two groups (χ = 0.50, p = 0.48). The univariate analysis revealed significant differences between the severe pneumonia group and the non-severe group in terms of gender distribution, presence of underlying chronic diseases, wheezing, premature delivery, lung wheezing rales, pneumothorax, bronchoscopy procedures, length of hospital stay, duration of symptoms prior to admission, neutrophil count, CRP levels, CKMB levels, IgA levels, CD3(%), CD3CD4(%), CD3CD8%, and CD3CD19% (all P < 0.05). Multivariate logistic regression analysis identified female gender, wheezing and neutrophil count were independent risk factors and the ratio of CD3CD4 cells was protective factor for severe HBoV pneumonia. The cut-off values of neutrophil count and the ratio of CD3CD4 cells were 6.81 × 10/L and 32.48 respectively.

CONCLUSION

Our study indicated that female gender, wheezing and neutrophil count greater than 6.81 × 10/L were independent risk factors and the ratio of CD3CD4 cells greater than 32.48 was protective factor for severe HBoV pneumonia.

摘要

背景

本研究旨在调查人博卡病毒（HBoV）感染所致重症肺炎的临床特征，以探索相关危险因素。

方法

我们对因HBoV肺炎住院的儿童数据进行了回顾性分析。根据肺炎严重程度，将患者分为重症肺炎组和非重症肺炎组。分析临床表现、实验室检查结果、胸部影像学及病原体情况。采用Logistic回归分析确定重症HBoV肺炎的危险因素。

结果

共收治334例患者，其中44例（13.17%）诊断为重症肺炎，290例（86.83%）为非重症肺炎。两组在年龄分布、发热、肺部湿啰音、胸腔积液及呼吸音减弱方面差异均无统计学意义（均P＞0.05）。57.19%的HBoV阳性儿童合并感染其他病原体，HRV是与HBoV合并感染最常见的病原体。两组合并感染率差异无统计学意义（χ² = 0.50，p = 0.48）。单因素分析显示，重症肺炎组与非重症组在性别分布、基础慢性病、喘息、早产、肺部哮鸣音、气胸、支气管镜检查、住院时间、入院前症状持续时间、中性粒细胞计数、CRP水平、CKMB水平、IgA水平、CD3（%）、CD3CD4（%）、CD3CD8%及CD3CD19%方面差异均有统计学意义（均P＜0.05）。多因素Logistic回归分析确定女性、喘息及中性粒细胞计数是重症HBoV肺炎的独立危险因素，CD3CD4细胞比值是保护因素。中性粒细胞计数及CD3CD4细胞比值的截断值分别为6.81×10⁹/L和32.48。