| Objective:To explore the clinical characteristics of BO in children with adenovirus type 7pneumonia,and to analyze the high risk factors for the development of BO in children with adenovirus type 7 pneumonia.To provide basis for clinical diagnosis and treatment of BO.In order to achieve early intervention,reasonably adjust the treatment plan,reduce the severity of BO and improve the long-term quality of life of children with BO.Methods:The clinical data of 184 children with adenovirus type 7 pneumonia hospitalized in Wuhan Children’s Hospital from October 2018 to October 2020 were analyzed retrospectively.According to whether they developed BO,children with adenovirus type 7pneumonia were divided into BO group(n = 84)and non-BO group(n = 88).SPSS 22.0software was used to analyze the clinical characteristics in acute state of BO in children with adenovirus type 7 pneumonia and the risk factors for the development of BO.Results:1.In this study,a total of 184 children with adenovirus type 7 pneumonia were collected,of which 12 cases(6.52%)died during hospitalization or gave up treatment and discharged,and 84 cases(45.65%)developed BO.2.Comparison of general condition between BO group and non-BO group:The average age of children in BO group was significantly younger than that in non-BO group[1.5(1.1,2.15)years vs.2.2(1.35,3.25)years](P<0.05).The proportion of preterm delivery(20 cases(23.8%)vs.8 cases(9.1%)),previous wheezing history(41 cases(48.8%)vs.24 cases(27.3%)),and underlying diseases(bronchopulmonary dysplasia,congenital heart disease,tracheomalacia,etc.)[26 cases(31.0%)vs.6 cases(6.8%)] in the BO group were significantly more higher than those in the non-BO group(P < 0.05).3.Comparison of clinical manifestations between BO group and non-BO group:The course of fever in BO group was significantly longer than that in non-BO group[12(10,17)d vs.9(7.5,12)d](P<0.05).The incidence of wheezing[46 cases(54.8%)vs.21 cases(23.9%)],shortness of breath [51 cases(60.7%)vs.28 cases(31.8%)]and hypoxemia[66cases(78.6%)vs.33 cases(37.5%)] in BO group was significantly higher than that in non-BO group.Compared with the non-BO group,patients in the BO group were more likely to be associated with invasive pulmonary fungal infections[30 cases(35.7%)vs.4 cases(4.5%)],and develop into into severe pneumonia[74 cases(88.1%)vs.55 cases(62.5%)],and be admitted to ICU[40 cases(47.6%)vs.13 cases(14.8%)],and be supported by mechanical ventilation[18cases(21.4%)vs.2 cases(2.3%)](P<0.05).The hospitalization days of children in BO group and non-BO group were 12(9 ～ 15)days and 9(7 ～ 13)days,respectively.The difference was statistically significant(P<0.05).4.Comparison of laboratory findings between BO group and non-BO group:The level of Hb and CD4/CD8 was significantly lower in the BO group[(97.65 ± 14.72g/L)vs.(101.91 ±13.05g/L);1.25(1.05,1.64)vs.1.57(1.15,2.22)](P<0.05).In contrast,the level of PCT was significantly higher in the BO group[2.28(0.84,4.5)vs.1.53(0.44,3.04)](P<0.05).5.Distribution of pathogens of invasive pulmonary fungal infections in children with HAdV-7 pneumonia:Among the 172 children with HAdV-7 pneumonia in this study,34 were diagnosed as invasive pulmonary fungal infections and 22 strains of pathogens were detected.Among them,Aspergillus was the most detected(12/22,54.55%).6.Comparison of imagings between BO group and non-BO group:The number of children with lung involvement > 3 lobes [56 cases(66.67%)vs.35 cases(39.77%)]and bronchiectasis[13 cases(15.5%)vs.1 case(1.1%)] in the BO group was significantly more than that in the non-BO group.7.By Logistic regression analysis,it was found that age(OR 0.607 95% CI 0.377-0.978),course of fever(OR 1.132 95%CI 1.027-1.247),underlying diseases(OR 4.207 95%CI1.213-14.597),CD4/CD8(OR 0.451 95%CI 0.218-0.932),hypoxemia(OR 3.699 95%CI1.343-10.188)and wheezing(OR 2.347 95%CI 1.035-5.324)were independent risk factors for BO after adenovirus type 7 pneumonia.Conclusions:The younger the age,the longer the course of fever,the lower the CD4/CD8 is,and the patients who associated with hypoxemia,wheezing or underlying diseases are more likely to be complicated with BO after adenovirus type 7 pneumonia. |
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