成人37例与儿童10例新型冠状病毒肺炎的临床特点比较

doi:10.6040/j.issn.1671-7554.0.2020.0740

摘要/Abstract

摘要： 目的探讨新型冠状病毒肺炎(COVID-19)患者儿童病例与成人病例临床特点的差异。方法分析山东大学附属济南市传染病医院收治的47例新型冠状病毒肺炎患者流行病学、临床症状、实验室检查、影像学检查及治疗方案,分为儿童组及成人组,对两组数据进行统计学分析。结果成人组家庭聚集病例多见,儿童组均为家庭内传播病例。儿童组患者发热、咳嗽、咽痛(咽痒)、乏力(肌肉酸痛)症状均低于成年组,差异有统计学意义(P<0.05),而胸闷、胸痛症状与成人组无明显差异;儿童组患者肺部影像学无改变比率高于成人组,差异有统计学意义(P<0.05);儿童组患者心肌酶增高比率高于成人组,差异有统计学意义(P<0.05),而肝酶、肌红蛋白、肌钙蛋白增高比率与成人组无明显差异;儿童组患者C-反应蛋白(CRP)、白介素-6(IL-6)、血清淀粉样蛋白酶A(SAA)增高比率低于成人组,差异有统计学意义(P<0.05);而降钙素原(PCT)增高,白细胞、淋巴细胞计数降低比率与成人组无明显差异;儿童组治疗方案较成人组简单。结论家庭内传播是儿童感染COVID-19的主要途径。相比于成人患者,儿童患者临床症状轻微,CT病变较轻,无明显肝损害及心肌损害,各炎症指标变化不明显。

关键词: 新型冠状病毒肺炎, 临床特点, 儿童病例

Abstract: Objective To explore the differences in clinical characteristics between children and adults with COVID-19. Methods The epidemiological characteristics, clinical symptoms, laboratory results, imaging results and treatment regimens of 37 adult and 10 children cases of COVID-19 were analyzed. Results Family clusters were more common in the adult group, while all children cases were caused by intra-family transmission. The adult group had a significantly higher incidence of symptoms such as fever, cough, pharyngeal pain(pharyngeal itch)and fatigue(muscle soreness)than the children group(P<0.05), while there is no difference in symptoms like chest tightness and chest pain. The children group had a higher rate of non-changing pulmonary imaging than the adult group(P<0.05). The children group had higher increase of myocardial enzyme than the adult group(P<0.05), while there were no differences in the increases of liver enzyme, myoglobin and troponin. The children group had lower increase of CRP, IL-6 and SAA than the adult group(P<0.05), while there were no significant differences in the increase of PCT and decreases of leukocyte and lymphocyte counts. The treatment regimen for the children group was simpler than that for the adults. Conclusion Intra-family transmission is the main way for children to catch COVID-19. Compared with adults, children have milder clinical symptoms, milder CT lesions, no obvious liver and myocardial damage, and no significant changes in inflammatory indicators.

Key words: Coronavirus disease 2019, Clinical characteristics, Children cases

中图分类号:

R512.99

王彬,布学慧,孔祥亘,张照华,吴谙诏,肖迪,蒋雪梅. 成人37例与儿童10例新型冠状病毒肺炎的临床特点比较[J]. 山东大学学报 (医学版), 2020, 58(10): 112-116.

WANG Bin, BU Xuehui, KONG Xianggen, ZHANG Zhaohua, WU Anzhao, XIAO Di, JIANG Xuemei. Comparison of the clinical characteristics between 37 adults and 10 children with COVID-19[J]. Journal of Shandong University (Health Sciences), 2020, 58(10): 112-116.

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