Clinical Characteristic Analysis Of Children With Severe Adenovirus Pneumonia In Our Hospital From 2012 To 2014

ObjectiveTo analyse the clinic characteristics of severe adenovirus pneumonia(SAP) in children and further to improve clinical diagnosis, treatment, prognosis of SAP.MethodsThe clinical materials of 189 cases with SAP in our hospital from January 2012 to December 2014 were retrospectively analyzed. Clinical manifestation, auxiliary examination, treatment and prognosis were analyzed.ResultsAmong 189 cases, 134(70.9%) children were aged 6 months to 2 years, with amales to females ratio of 2.5:1. 186 patients had fever, 116(61.4%)with high temperature of 40.0℃~41.9℃, fever lasting 10.8 days on average. All patients had cough, 118(62.4%) with wheeze, 185(97.7%) with moist rales and 156(82.5%) with wheezing in the lung. SAP was easily combined with other pathogenic infections, Streptococcus pneumoniae and respiratory syncytial virus were the most common bacterial pathogen and the most common virus, in addition, mycoplasma pneumoniae is also common. Laboratory examinations showed prone WBC, CRP, PCT, AST, ALT increased, and Hb, albumin decreases. Most of the imaging findings of chest of SAP were exudative change and consolidation in both lungs. Bronchoscopy showed chronic tracheal bronchus infective endocarditis in most patients.Heart doppler ultrasound showd congenital heart disease in 23 patients. 183(96.8%) patients have complications. Respiratory failure, pleuritis, pulmonary atelectasis and ARDS were common among intrapulmonary complications. Diseases of digestive system and nercous system were the most common ones among extrapulmonary complications. Treatment of SAP was comprehensive. Univariate Logistic regression analys is showed that: Hb<90g/L, plasma albumin<30g/L, CRP>30mg/L, PCT>10ng/ml, AST>100U/L, ALT>100U/L, congenital dysplas ia of the airway, ARDS, circulatory complications, acid electrolyte balance disorder and more than three kinds of complications may have adverse impact on the outcomes(p<0.05). Multivariable Logistic regression analysis showed that: AST> 100U/L is the independent predictive factor of children with SAP.Conclusions1.The clinical manifestations of SAP is serious.And SAP patients could easily suffer multiple complications. Its treatment process emphasizes early recognition, early diagnosis, comprehensive treatment and prevention of complications.2. AST> 100U/L is the independent predictive factor of children with SAP.