Analysis of risk factors for measles complicated with pneumonia in children
10.3760/cma.j.cn311365-20191107-00365
- VernacularTitle:儿童麻疹并发肺炎的危险因素分析
- Author:
Dongxiao LIU
1
;
Lihua ZHANG
;
Haixia GAO
;
Qiang LI
Author Information
1. 山东大学附属济南市传染病医院重症医学科 250021
- From:
Chinese Journal of Infectious Diseases
2020;38(12):792-797
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the demographic, epidemiological and clinical characteristics of measles in children, and to explore the risk factors for measles complicated with pneumonia in children.Methods:Children with measles aged≤18 years who were hospitalized in Jinan Infectious Disease Hospital from January 1, 2014 to December 31, 2018 were included. The demographic, epidemiological, clinical and laboratory data of inpatients were collected. The features of patients with pneumonia were analyzed. The risk factors of pneumonia were analyzed by chi-square test and multivariate logistic regression.Results:A total of 1 730 patients were recruited, including 423 patients (24.5%) in 2014, 437 patients (25.3%) in 2015, 856 patients (49.5%) in 2016, 10 patients (0.6%) in 2017 and four patients (0.2%) in 2018. The male to female ratio was 2∶1. The age ranged from four days to 18 years, and 1 572 patients (90.9%) were under three years old. There were 1 381 patients (79.8%) living in rural areas and 83 patients (4.8%) born with low birth weight. Two hundred and twenty-nine patients (13.2%) had a history of respiratory diseases within half a year before measles onset, and 1 489 patients (86.1%) had not been vaccinated before. According to the presence of pneumonia, 1 730 children with measles were divided into pneumonia group ( n=1 295) and non-pneumonia group ( n=435). There were more patients with bucking in pneumonia group than those in non-pneumonia group (56.8%(735/1 295) vs. 40.9%(178/435), χ2=32.770, P<0.01). Zero point seven percent (12/1 730) of children were critically ill, and 0.5%(8/1 730) of children died, all of whom were in pneumonia group. The white blood cell count, the percentage of white blood cell count>10×10 9/L, neutrophilic granulocyte count, the percentage of neutrophilic granulocyte count>7×10 9/L, C reactive protein level, the percentage of C reactive protein level>8.2 mg/L, procalcitonin level, the percentage of procalcitonin>0.5 ng/L, the percentage of hemoglobin level<110 g/L, and the percentage of albumin<35 g/L in pneumonia group were all significantly higher than those in non-pneumonia group ( t=7.153, χ2=47.239, t=8.297, χ2=41.176, Z=-6.769, χ2=40.131, Z=-4.119, χ2=19.284, χ2=7.465, χ2=18.356, respectively, all P<0.01). Multivariate logistic regression analysis showed that male (odds ratio ( OR)=1.316), living in rural areas ( OR=1.521), age7×10 9/L ( OR=3.666), and C reactive protein level >8.2 mg/L ( OR=1.871), procalcitonin>0.5 ng/L ( OR=1.711) were independent risk factors for pneumonia in children with measles. Conclusions:Measles vaccination in children should be farther strengthened. Male, children living in rural areas, low birth weight, history of respiratory diseases before measles and without measles vaccination are prone to be complicated with pneumonia, and special medical attention should be given.
