关键词:

腺病毒, 肺炎支原体, 临床特征, 儿童

Abstract: Objective　To investigate the clinical characteristics in children with adenovirus (ADV) combined with Mycoplasma pneumoniae (MP) infection, and to provide reference for clinical treatment. Methods　This was a case-control study. A total of 109 cases of ADV infected children admitted to Yuexiu District Children's Hospital of Guangzhou from May 2022 to May 2023 were classified as an ADV group, and 57 children with ADV combined with MP infection as an ADV+MP group. The general data (gender, age of onset, heat course, body mass index, etc.), clinical features [wheeze, shortness of breath, fever, rales, cough, pleural effusion, extrapulmonary complications, severe pneumonia, and Clinical Pulmonary Infection Score (CPIS)], imaging results, laboratory indicators [procalcitonin (PCT), white blood cell count (WBC), C-reactive protein (CRP), serum amyloid A (SAA), immunoglobulin (Ig) A, IgG, IgM, IgE, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH)], and clinical treatment (oxygen therapy, glucocorticoids, gammaglobulin use, length of hospital stay, hospital cost, rehospitalization rate for respiratory infection within 3 months) were compared between the two groups. Independent sample t test and χ2 test were used for statistical analysis. Results　There were 59 boys and 50 girls in the ADV group, 30 boys and 27 girls in the ADV+MP group, without statistically significant difference between the two groups (P>0.05). The age of onset in the ADV+MP group was lower than that in the ADV group [(4.32±1.25) years old vs. (5.24±1.01) years old], and the heat course was longer than that in the ADV group [(8.40±1.93) d vs. (5.54±2.12) d] (both P<0.05). The rates of rales, pleural effusion, and severe pneumonia and CPIS in the ADV+MP group were higher than those in the ADV group [68.42% (39/57) vs. 50.46% (55/109), 10.53% (6/57) vs. 2.75% (3/109), 29.82% (17/57) vs. 14.68% (16/109), (5.19±0.92) points vs. (4.33±1.27) points] (all P<0.05). The rates of lung consolidation and bilateral lung involvement in the ADV+MP group were higher than those in the ADV group [47.37% (27/57) vs. 29.36% (32/109), 63.16% (36/57) vs. 45.87% (50/109)] (both P<0.05). The WBC level in the ADV+MP group was lower than that in the ADV group [(11.63±3.95) ×109/L vs. (13.22±4.47) ×109/L], and the levels of CRP, SAA, IgM, and LDH were higher than those in the ADV group [(16.94±3.06) mg/L vs. (10.78±2.19) mg/L, (72.94±22.46) mg/L vs. (65.17±19.37) mg/L, (1.59±0.31) g/L vs. (1.22±0.43) g/L, (359.81±59.43) U/L vs. (313.44±51.32) U/L] (all P<0.05). The rates of oxygen therapy and gammaglobulin use, length of stay, hospitalization cost, and rehospitalization rate for respiratory infection within 3 months in the ADV+MP group were higher than those in the ADV group [40.35% (23/57) vs. 14.68% (16/109), 19.30% (11/57) vs. 1.83% (2/109), (8.67±1.52) d vs. (7.19±1.23) d, (4 518.59±1 241.85) yuan vs. (3 924.46±1 057.33) yuan, 14.04% (8/57) vs. 3.67% (4/109)] (all P<0.05). Conclusion　The inflammatory symptoms and clinical symptoms of ADV and MP infected children are more severe, the need for oxygen therapy and gammaglobulin is greater, and the risk of hospitalization is higher after recovery, suggesting that timely targeted treatment measures should be taken.

Key words:

Adenovirus, Mycoplasma pneumoniae, Clinical features, Children