儿童3型腺病毒肺炎预后影响因素分析

doi:10.12372/jcp.2025.24e1412

Abstract

Abstract:

Objective To analyze the clinical characteristics of children with respiratory adenovirus type 3 infection and the influencing factors of adenovirus type 3 pneumonia in children. Methods A retrospective analysis was conducted on the clinical data of children with respiratory adenovirus type 3 infection admitted to the hospital's infectious disease department from January to October 2024. The possible influencing factors of the occurrence of adenovirus type 3 pneumonia were analyzed through multivariate logistic regression. Results A total of 159 children (87 boys and 72 girls) with adenovirus type 3 infection were included, with a median age of 59.0 (41.0-81.0) months. Multivariate logistic regression analysis showed that tonsillar exudation and elevated CRP level were independent protective factors for adenovirus type 3 pneumonia in children (P<0.05), while cough, expectoration and elevated D-dimer level were independent risk factors for adenovirus type 3 pneumonia (P<0.05). Conclusions In the early course of respiratory adenovirus type 3 infection in children, tonsillar exudation may indicate mild pulmonary symptoms, suggesting that the tonsils may play an important defensive role in the immune response of acute adenovirus infection.

Key words: adenovirus type 3, pneumonia, tonsillar exudation, child

CLC Number:

XIANG Linjuan, CHEN Xuexin, JIA Yanhui, WU Yuhang, CONG Xin, LI Wei, CHEN Yingying, CHEN Sun, HUANG Lisu. Prognostic factors analysis of adenovirus type 3 pneumonia in children[J].Journal of Clinical Pediatrics, 2025, 43(9): 686-691.

Figures/Tables 2

Table 1

Comparison of clinical characteristics between the HAdV-B3 pneumonia group and the non-pneumonia group"

项目	HAdV-B3非肺炎组(n=73)	HAdV-B3肺炎组(n=86)	统计量	P
年龄[M(P₂₅~P₇₅)]/月	59.6(44.0~79.0)	56.5(35.5~83.5)	Z=0.96	0.336
男性[n(%)]	33(45.21)	54(73.97)	χ²=4.93	0.026
热峰[M(P₂₅~P₇₅)]/℃	40.0(39.2~40.2)	39.6(39.0~40.0)	Z=2.02	0.044
发热天数[M(P₂₅~P₇₅)]/d	6.0(5.0~7.9)	6.0(4.8~8.0)	Z=0.60	0.547
基础疾病[n(%)]	12(16.4)	13(15.1)	χ²=0.05	0.819
入院临床表现[n(%)]
咳嗽、咳痰	51(69.9)	82(95.3)	χ²=16.93	<0.001
喘息	3(4.1)	21(24.4)	χ²=11.17	0.001
扁桃体渗出	24(32.9)	13(15.1)	χ²=6.98	0.008
腹痛	19(26.0)	12(14.0)	χ²=3.67	0.055
腹泻	8(11.0)	7(8.1)	χ²=0.37	0.544
呕吐	26(35.6)	19(22.1)	χ²=3.56	0.059
头痛	8(11.0)	4(4.7)	χ²=1.44	0.230
皮疹、红斑	6(8.2)	6(7.0)	χ²=0.09	0.768
颈部淋巴结肿大	20(27.4)	9(10.5)	χ²=7.59	0.006
肝脾肿大	3(4.1)	6(7.0)	χ²=0.19	0.663
入院实验室检查[M(P₂₅~P₇₅)]
血常规
白细胞计数×10⁹·L^-1	9.6(6.3~13.8)	8.2(5.7~12.4)	Z=1.37	0.169
中性粒细胞计数×10⁹·L^-1	6.5(3.3~10.4)	4.8(2.7~8.4)	Z=1.87	0.061
单核细胞计数×10⁹·L^-1	0.7(0.4~1.2)	0.6(0.5~1.2)	Z=0.75	0.453
淋巴细胞计数×10⁹·L^-1	2.0(1.3~3.3)	2.3(1.8~3.4)	Z=1.68	0.093
血红蛋白/g·L^-1	117.0(111.0~123.0)	117.5(113.8~123.0)	Z=0.67	0.504
血小板计数×10⁹·L^-1	251.0(216.0~325.5)	308.0(253.3~371.0)	Z=2.72	0.007
CRP/mg·L^-1	28.2(10.1~53.0)	12.3(4.7~30.6)	Z=2.92	0.004
PCT/ng·mL^-1	0.4(0.2~0.8)	0.2(0.1~0.6)	Z=2.19	0.028
红细胞沉降率/mm·h^-1	22.0(12.4~31.4)	22.5(14.9~34.2)	Z=0.58	0.565
ALT/U·L^-1	13.5(11.0~17.3)	13.0(11.0~17.0)	Z=0.09	0.931
LDH/U·L^-1	322.5(240.0~698.5)	289.0(241.5~396.5)	Z=1.61	0.106
铁蛋白/μg·L^-1	89.6(71.9~111.8)	100.5(70.6~126.0)	Z=0.97	0.331
D-二聚体/mg·L^-1	0.3(0.2~0.4)	0.4(0.3~0.5)	Z=3.79	<0.001
纤维蛋白原/g·L^-1	3.8(3.5~4.3)	3.8(3.1~4.4)	Z=0.83	0.409

Table 1

Table 2

References 31

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因素	偏回归系数	标准误	χ²值	OR(95%CI)	P
咳嗽、咳痰	3.76	1.02	13.60	43.10(5.83~318.64)	<0.001
扁桃体渗出	－1.47	0.50	8.87	0.23(0.09~0.60)	0.003
CRP	－0.02	0.01	7.53	0.98(0.96~0.99)	0.006
D-二聚体	3.52	1.17	9.11	33.91(3.44~334.40)	0.003
常量	－3.42	1.19	8.22	－	0.004

Prognostic factors analysis of adenovirus type 3 pneumonia in children

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