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投稿时间：2024-11-13 网络发布日期：2025-10-20
投稿时间：2024-11-13 网络发布日期：2025-10-20
中文摘要: 目的 探讨儿童腺病毒肺炎重症腺病毒肺炎并发心功能障碍的危险因素，评估不同临床变量对心功能障碍的影响。方法 选取2023年6月至2024年6 月在南京儿童医院及南京医科大学第四附属医院住院的125例重症腺病毒肺炎患儿为研究对象，收集其一般临床资料及实验室结果，包括年龄、性别、病史、乳酸脱氢酶、肌酸激酶等指标。根据是否并发心功能障碍，将患儿分为心功能障碍组与心功能正常组，并采用logistic回归模型分析潜在风险因素。结果 心功能障碍组为44例（35.2%），心功能正常组为81例，其中心功能障碍组发热时间［（14.57±1.09）d vs（10.65±0.59）d］、低氧血症发生率（61.4% vs 30.9%）显著高于心功能正常组（P<0.05）。心功能障碍组合并支原体感染率高于心功能正常组（61.4% vs 32.1%），差异有统计学意义（P<0.05）。与心功能正常组相比，心功能障碍组中性粒细胞比率、C反应蛋白、乳酸脱氢酶、肌酸激酶同工酶水平和营养性贫血比例显著增高，而淋巴细胞比率显著降低（P<0.05）。多因素 logistic 回归分析显示，在调整潜在混杂因素后，营养性贫血（OR=7.843，95%CI：2.197~28.003，P = 0.002）、合并肺炎支原体感染（OR=7.489，95%CI：2.426~23.120，P=0.001）是发生心功能障碍的独立危险因素。结论 儿童重症腺病毒肺炎合并心功能障碍的发生与合并支原体感染、营养性贫血密切相关。对存在以上因素的重症腺病毒肺炎患儿应尽早临床干预以改善预后。
Abstract:Objective To explore the risk factors for heart dysfunction in children with severe adenovirus pneumonia，and to assess the impact of different clinical variables on heart dysfunction. Methods A total of 125 children with severe adenovirus pneumonia admitted to Nanjing Children’??s Hospital and the Fourth Affiliated Hospital of Nanjing Medical University from June 2023 to June 2024 were selected as study subjects. General clinical data and laboratory Results ，including age，gender，medical history，lactate dehydrogenase，creatine kinase，and other indicators，were collected. Based on the presence or absence of heart dysfunction，children were divided into a heart dysfunction groupand a normal heart function group. A logistic regression model was used to analyze potential risk factors. Results The heart dysfunction group comprised 44 cases（35.2%），while the normal heart function group included 81 cases. The duration of fever［（14.57 ± 1.09）d vs（10.65 ± 0.59）d］and the incidence of hypoxemia（61.4% vs 30.9%）were significantly higher in the heart dysfunction group than in the normal heart function group（P<0.05）. The rate of concomitant Mycoplasma pneumoniae infection was higher in the heart dysfunction group compared to the normal heart function group（61.4% vs 32.1%），with a statistically significant difference（P<0.05）. Compared to the normal heart function group，the heart dysfunction group had significantly higher neutrophil ratios，C - reactive protein，lactate dehydrogenase，creatine kinase isoenzyme levels，and proportion of nutritional anemia，but had lower lymphocyte ratios（P<0.05）. Multivariable logistic regression analysis，adjusted for potential confounders，identified that nutritional anemia（OR=7.843，95%CI：2.197- 28.003，P=0.002），Mycoplasma pneumoniae co - infection（OR=7.489，95%CI：2.426-23.120，P=0.001）were independent risk factors for heart dysfunction complicating severe adenovirus pneumonia（P<0.05）. Conclusion The development of heart dysfunction in children with severe adenovirus pneumonia is significantly associated with concurrent Mycoplasma pneumoniae infection and nutritional anemia. Early clinical intervention for children with severe adenovirus pneumonia who have these factors should be considered to improve prognosis.
keywords: Adenovirus pneumonia, Severe Heart dysfunction Mycoplasma pneumoniae infection Nutritional anemia Children Community-acquired pneumonia
文章编号： 中图分类号：R725.6 文献标志码：A
基金项目:南京市卫生科技发展专项资金项目（YKK23208）；南京医科大学科技发展基金项目（NMUB20230039）；南京医科大学第四附属医院院级人才青年探索项目（23YJRC24）
附件
| Author Name | Affiliation |
| WANG Boheng*，YIN Rui，XU Xueping，TIAN Man，WANG Weiyuan，GAO Tian，DING Ling | *Nanjing Medical University,Nanjing,Jiangsu 211166,China |
引用文本：
王博恒,殷睿,徐雪萍,等.儿童重症腺病毒肺炎并发心功能障碍的危险因素分析[J].中国临床研究,2025,38(10):1580-1584.
王博恒,殷睿,徐雪萍,等.儿童重症腺病毒肺炎并发心功能障碍的危险因素分析[J].中国临床研究,2025,38(10):1580-1584.