中国循证儿科杂志2025，Vol.20Issue(4)：294-299,6.DOI:10.3969/j.issn.1673-5501.2025.04.009
人偏肺病毒感染肺炎住院患儿临床特征及重症危险因素的病例对照研究
Analysis of clinical characteristics and severe risk factors in hospitalized children with hu-man Metapneumovirus pneumonia:A case-control study
摘要
Abstract
Background Human Metapneumovirus(HMPV)is a significant pathogen causing respiratory infections in chil-dren and can lead to severe inflammatory diseases such as severe pneumonia.Objective To analyze the clinical characteristics of pediatric HMPV pneumonia and identify risk factors associated with severe pneumonia.Design Retrospective case-control study.Methods The study retrospectively enrolled 158children diagnosed with HMPV pneumonia and hospitalized in the Respira-tory Department and Infectious Disease Department of Tianjin Children's Hospital(Machang Campus)from April 2023 to Decem-ber 2024.Based on diagnostic criteria for community-acquired pneumonia,patients were classified into severe and mild groups.De-mographic data,clinical features,laboratory findings,and treatment regimens were collected to analyze differences in clinical manifestations between the two groups and identify risk factors for severe pneumonia.Main outcome measures Clinical charac-teristics of pediatric HMPV pneumonia and risk factors associated with severe pneumonia.Results Among the 158 children,the median age was 3 years(IQR 1-5),with 86.7％under 5 years old.Males accounted for 59.5％(94 cases)and females 40.5％(64 cases).Incidence peaked annually in March,April and May.Clinical manifestations included fever(146 cases,92.4％),cough(158 cases,100％),and wheezing(48 cases,30.4％).Severe pneumonia was observed in 52 cases(32.9％)and mild pneumonia in 106 cases(67.1％).The severe group,compared to the mild group,had older age[4(IQR 2-5)vs.3(IQR 2-5)years],longer hospitalization and fever duration[8(IQR 6-9)vs.6(IQR 5-7)days;4(IQR 3-5)vs.2.5(IQR 1-4)days],higher peak fever[39.8℃(IQR 39.0-40.0)vs.39.0℃(IQR 38.5-39.5)],faster heart rate[120(IQR 108-135)vs.111(IQR 100-120)],lower oxy-gen saturation[0.94(IQR 0.92-0.98)vs.0.98(IQR 0.97-0.99)],and higher Pediatric Early Warning Scores[0(IQR 0-1)vs.0(IQR 0-0)](P<0.05).The severe group also exhibited reduced lymphocyte counts and elevated neutrophil counts,neutrophil-to-lymphocyte ratio,C-reactive protein,procalcitonin,and interleukin-6 levels(P<0.05).Co-infections occurred in 64 cases(40.5％):33 in the severe group and 31 in the mild group.Chest imaging revealed unilateral or bilateral patchy consolidations in 134 cases(84.8％),while 24 cases(15.2％)showed large consolidations on CT,including 5 with atelectasis.Treatments included systemic corticosteroids(45 cases,28.5％),human immunoglobulin(6 cases,3.8％),and bronchoscopic lavage(19 cases,12.0％).Significant differences(P<0.05)were observed between the severe and mild groups in co-infection rates,large consolida-tions,atelectasis,and use of corticosteroids,immunoglobulin,and bronchoscopy.All patients recovered and were discharged.Lo-gistic regression analysis identified elevated peak fever(OR=3.189,95％CI:1.355-7.505),reduced oxygen saturation(OR=0.406,95％CI:0.260-0.632),large pulmonary consolidations(OR=0.093,95％CI:0.019-0.458),and co-infection(OR=0.213,95％CI:0.059-0.766)as independent risk factors for severe HMPV pneumonia.Conclusion Pediatric HMPV pneumo-nia primarily manifests with cough,fever,and wheezing.Severe pneumonia cases are prevalent and often co-occur with other patho-gens.Chest imaging predominantly shows unilateral or bilateral patchy inflammatory consolidations,while severe cases exhibit a higher proportion of large consolidations.Elevated peak fever,hypoxemia,large pulmonary consolidations,and co-infection are significant risk factors for severe HMPV pneumonia.关键词
人偏肺病毒/肺炎/儿童/危险因素Key words
Human Metapneumovirus/Pneumonia/Child/Risk factor引用本文复制引用
郭润,邹映雪,王雪琳,贠亚男..人偏肺病毒感染肺炎住院患儿临床特征及重症危险因素的病例对照研究[J].中国循证儿科杂志,2025,20(4):294-299,6.基金项目
天津市自然科学基金重点项目:20JCZDJC00630 （）
天津市医学重点学科(专科)建设项目:TJYXZDXK-040A （专科）
