Analysis Of Risk Factors For Pneumonia In Patients With Influenza A Virus Infection

Objective:Influenza is still a seasonal high incidence,pneumonia is the main complication,seriously affecting the prognosis of patients.By retrospectively analyzing the clinical data of patients infected with influenza A with or without pneumonia,this study focused on the clinical characteristics of patients with pneumonia and the risk factors affecting the occurrence of pneumonia,so as to provide a theoretical basis for early clinical detection and timely treatment,reduce the mortality rate and reduce the disease burden.Methods:Selected from November 2017 to December 2018 in the Second People’s Hospital of Weifang,hospitalized in the Department of Respiratory Medicine,through nasopharyngeal swabs,sputum,bronchoalveolar lavage fluid and other specimens(all collected by professionals),after reversal The polymerase chain reaction(RT-PCR)method was used to record the clinical data of patients(age≥18years old)who were diagnosed as positive for influenza A virus infection and complicated with pneumonia.At the same time,select influenza A virus infection positive but no evidence of pneumonia at the same time hospitalized Of patients served as a control group.Through the in-hospital case system,the general information,clinical manifestations,laboratory results,imaging results,treatment and prognosis data of the selected population are sorted,and the patients are divided into the non-pneumonia group(non-pneumonia)of influenza A infection according to the research purpose and relevant guidelines.Group)and the pneumonia group(pneumonia group).Retrospective analysis is used to study the clinical characteristics of patients with influenza A and pneumonia and the risk factors that affect the occurrence of pneumonia,further deepen the understanding of influenza-related pneumonia,and strive to improve the prevention and management of such patients.Results:From November 2017 to December 2018 in the Second People’s Hospital of Weifang,a total of 964 patients with positive influenza infection in the respiratory department were screened by the inclusion and exclusion criteria,and 619 cases were retained,including 300 in the non-pneumonia group and 319 in the pneumonia group example.(1)Basic information and epidemiological description:(1)There were 164males and 136 females in the non-pneumonia group,with a ratio of 1.2 between men and women,174 males in the pneumonia group,and 145 females with a ratio of 1.2between the two groups.There was no statistically significant difference in gender between the two groups.(2)In the pneumonia group,there were 43(13.5)patients with BMI≥28kg/m~2,and there were more obese patients.(3)The difference between smoking and influenza vaccination groups was statistically significant(P<0.01).There were more smokers in the pneumonia group,but fewer vaccinated patients than the control group.(2)Clinical symptoms:The main clinical manifestations of patients in the pneumonia group are:cough,sputum expectoration,dyspnea,fever,anorexia and malaise.(3)Underlying diseases:Patients with COPD,bronchial asthma,bronchiectasis,diabetes or heart disease are more likely to develop pneumonia,and there is a significant difference between the two groups(P<0.05).(4)Laboratory results:(1)Inflammatory indicators such as:CRP,WBC,NEU#,NEU%,LYM#,LYM%were statistically different between the two groups(P<0.05),and the inflammation in the pneumonia group was more intense,Lymphocyte reduction is more significant.(2)The AST,CK-MB,and LDH indexes were significantly different between the two groups(P<0.05),indicating that the pneumonia group was more likely to have liver and myocardial damage in the early stage.(3)The difference in Pa O2/Fi O2 between the two groups was also statistically significant(P<0.01).The oxygenation index of the pneumonia group was low,with an average of(284.98±79.58)mm Hg.(5)Imaging results:80%of patients in the pneumonia group showed patchy,ground-glass shadows,and consolidation was rare(5.3%).Images of bronchiectasis and bullae were more common in the pneumonia group(P<0.01).It may be related to the complex underlying lung diseases in this group of patients.(6)Diagnosis and treatment:Patients in the pneumonia group are more likely to require invasive mechanical ventilation(P<0.05),and more likely to use hormone therapy before hospitalization(P<0.05).(7)Complications:(1)Patients in the pneumonia group are more prone to secondary infections and respiratory failure,which is also an important factor affecting the prognosis.(2)This study found that the detection rates of Aspergillus,Streptococcus pneumoniae,and Mycobacterium were significantly different between the two groups(P<0.01).There were more cases of secondary infection in the pneumonia group.(8)Multivariate logistic regression showed that advanced age(≥65years),obesity,COPD,bronchiectasis,diabetes,heart disease,and secondary infection were risk factors affecting influenza A infection with pneumonia(P<0.05).Conclusion:(1)advanced age(≥65years),obesity,COPD,bronchiectasis,diabetes,heart disease,and secondary infections are risk factors that affect influenza A and pneumonia.(2)After the elderly population is infected with influenza A,it may not be a typical flu-like case,but the deterioration of the original disease,and should be vigilant.(3)Patients with influenza A infection and pneumonia are prone to increase in LDH,LDH can reflect the degree of lung injury and has a certain relationship with whether or not they have pneumonia.(4)Influenza infection may be another host factor for invasive fungal diseases.