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| Analysis of clinical features of measles complicated with pneumonia in children |
| WANG Yu WANG Sitong CAI Miaotian ZHANG Zhili ZHANG Yulin |
| Department of Respiratory and Critical Care Medicine, Capital Medical University, Beijing Youan Hospital, Beijing 100069, China |
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Abstract Objective To explore the clinical characteristics of measles complicated with pneumonia in children and to provide reference for the diagnosis and treatment of children with measles. Methods A retrospective study was conducted to collect the clinical data, including demographic data, measles infection, and laboratory results, of 0-18 year old children with measles who were first diagnosed with measles in Beijing Youan Hospital, Capital Medical University from June 2010 to June 2022. The children were divided into pneumonia group and non-pneumonia group according to whether they were complicated with pneumonia. The clinical data were analyzed and summarized. Results Among 671 children with measles, a total of 601 cases were complicated with pneumonia, most of them were male, and few complications were complicated. The clinical manifestations were fever, cough, and rash. The age of onset in the pneumonia group was lower than that in the non-pneumonia group, and the proportion of previous history was higher than that in the non-pneumonia group, and the differences were statistically significant (P＜0.05). There were significant differences in the proportion of cough, Collinia spot, total complication rate, and gastroenteritis between the two groups (P＜0.05). The median indexes of white blood cell count, neutrophil count, C-reactive protein, and creatinine in pneumonia group were higher than those in non-pneumonia group, and the differences were statistically significant (P＜0.05). The proportion of antibiotics used in pneumonia group was higher than that in non-pneumonia group, and the difference was statistically significant (P＜0.05). The proportion of antiviral drugs used in pneumonia group was lower than that in non-pneumonia group, and the difference was statistically significant (P＜0.05). The hospitalization days in the pneumonia group were longer than that in the non-pneumonia group, and the difference was statistically significant (P＜0.05). Conclusion Pneumonia is the main complication of measles, and the clinical manifestations of children with measles comp- licated with pneumonia are more serious than those without measles complicated with pneumonia. Understanding the clinical manifestations and laboratory examination results of measles complicated with pneumonia is helpful to judge the prognosis and provide guidance for correct treatment.
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[1] Griffin DE. Measles immunity and immunosuppression [J]. Current Opinion Virology，2021，46：9-14.
[2] World Health Organization. Measles [EB/OL].（2022-11-23）[2022-12-03].https：//www.who.int/zh/news/item/23-11-2022- nearly-40-million-children-are-dangerously-susceptible- to-growing-measles-threat.
[3] Lindberg C，Lanzi M，Lindberg K. Measles：Still a Significant Health Threat [J]. MCN Am J Matern Child Nurs，2015，40（5）：2985.
[4] 中华人民共和国国家卫生和计划生育委员会.麻疹诊断[J].传染病信息，2017，30（4）：181-189.
[5] 中华医学会儿科学分会呼吸学组，《中华儿科杂志》编辑委员会.儿童社区获得性肺炎管理指南（2013修订）（上）[J].中华儿科杂志，2013，51（10）：745-752.
[6] 中华医学会儿科学分会呼吸学组，《中华儿科杂志》编辑委员会.儿童社区获得性肺炎管理指南（2013修订）（下）[J].中华儿科杂志，2013，51（11）：856-862.
[7] Ferren M，Horvat B，Mathieu C. Measles Encephalitis：Towards New Therapeutics [J]. Viruses，2019，11（11）：1017.
[8] Moss WJ. Measles [J]. Lancet，2017，390（10111）：2940- 2502.
[9] Porter A，Goldfarb J. Measles：A dangerous vaccine-preventable disease returns [J]. Cleve Clin J Med，2019，86（6）：393-398.
[10] Stein RA. Hypoxic respiratory failure in measles-associated pneumonia [J]. Int J Clin Pract，2020，74（2）：e13456.
[11] Dominguez A，Plans P，Costa J，et al. Seroprevalence of me- asles，rubella，and mumps antibodies in Catalonia，Spain：results of a cross-sectional study [J]. Eur J Clin Microbiol Infect Dis，2006，25：310-317.
[12] Kontio M，Palmu AA，Syrj?覿nen RK，et al. Similar antibody levels in 3-year-old children vaccinated against measles，mumps，and rubella at the age of 12 months or 18 months [J]. J Infect Dis，2016，213：2005-2013.
[13] Green MS，Shohat T，Lerman Y，et al. Sex differences in the humoral antibody response to live measles vaccine in young adults [J]. Int J Epidemiol，1994，23（5）：1078-1081.
[14] Bolotin S，Severini A，Hatchette T，et al. Assessment of population immunity to measles in Ontario，Canada：a Canadian Immunization Research Network （CIRN）study [J]. Hum Vaccin Immunother，2019，15：2856-2864.
[15] Rota PA，Moss WJ，Takeda M，et al. Measles [J]. Nature Reviews Disease Primers，2016，2：16049.
[16] Plemper RK. Measles Resurgence and Drug Development [J]. Curr Opin Virol，2020，41：8-17.
[17] Leung AK，Hon KL，Leong KF，et al. Measles：a disease often forgotten but not gone [J]. Hong Kong Med J，2018，24（5）：512-520.
[18] Mina MJ. Measles，immune suppression and vaccination：direct and indirect nonspecific vaccine benefits [J]. J Infect，2017，74 Suppl 1：S10-S17.
[19] Ben-Chetrit E，Oster Y，Jarjou’i A，et al. Measles-related hospitalizations and associated complications in Jerusalem，2018-2019 [J]. Clin Microbiol Infect，2020，26（5）：637-642.
[20] Gouandjika-Vasilache I，Dina J. Measles [J]. Lancet，2022， 399（325）：678-690.
[21] Li Y，Min L，Zhang X. Usefulness of procalcitonin （PCT），C-reactive protein（CRP），and white blood cell （WBC） levels in the differential diagnosis of acute bacterial，viral，and mycoplasmal respiratory tract infections in children [J]. BMC Pulm Med，2021，21（1）：386.
[22] Casaos J，Gorelick NL，Huq S，et al. The Use of Ribavirin as an Anticancer Therapeutic：Will It Go Viral？ [J]. Mol Can- cer Ther，2019，18（7）：1185-1194.
[23] Ison MG. Antiviral Treatments [J]. Clin Chest Med，2017， 38（1）：139-153.
[24] 范娟，李茂军，吴青，等.儿童麻疹的临床管理-美国传染病学会2015年报告简[J].中华实用儿科临床杂志，2015，30（22）：1684-1686.
[25] Griffin DE. Measles virus persistence and its consequences [J]. Curr Opin Virol，2020，41：46-51. |
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