关键词: 社区获得性肺炎, 婴幼儿, 重症肺炎, 临床表现, 预后, 影响因素

Abstract:

Objective To analyze the clinical manifestations and prognostic factors of severe pneumonia in infants and young children, and to provide a reference for clinical diagnosis and treatment. Methods Clinical data of 304 infants and young children with severe pneumonia admitted to our hospital from November 2021 to November 2025 were collected, and their clinical characteristics were summarized. According to the 1-month post-discharge follow-up results, the children were divided into a good prognosis group (n=256) and a poor prognosis group (n=48). General information, use of mechanical ventilation, mixed infection, and the occurrence of complications (heart failure and respiratory failure) were compared between the two groups. Multivariate logistic regression analysis was used to identify factors associated with poor prognosis in infants and young children with severe pneumonia. Results Among the 304 children, 54.61% (166/304) were male, the mean age was (1.42±0.41) years, and 24.34% (74/304) were preterm at birth. Pathogenic specimens were detected in 268 cases, with a detection rate of 88.16%. Viral infection was the main pathogen type (46.05%). Mixed infection accounted for 19.08% (58/304), with virus-bacteria mixed infection being the most common (68.97%). The main clinical manifestations were fever (82.89%, 252/304), cough (92.76%, 282/304), shortness of breath (88.82%, 270/304), nasal flaring (67.11%, 204/304), and three-concave sign (64.47%, 196/304). The incidence of convulsions was 11.84% (36/304), and poor appetite was 61.18% (186/304). The main complications were respiratory failure (27.0%, 82/304) and heart failure (20.39%, 62/304). Compared with the good prognosis group, children in the poor prognosis group were younger, had lower birth weight, had a higher proportion of preterm birth, and showed higher rates of mechanical ventilation use, mixed infection, concomitant heart failure, and respiratory failure (P<0.05). Multivariate logistic regression analysis showed that concomitant heart failure and concomitant respiratory failure were independent risk factors for poor prognosis in infants and young children with severe pneumonia (P<0.05). Conclusion Severe pneumonia in infants and young children presents with diverse clinical manifestations, mainly respiratory symptoms and systemic inflammatory responses. Concomitant heart failure or respiratory failure increases the risk of poor prognosis.

Key words: community-acquired pneumonia, infants and young children, severe pneumonia, clinical manifestations, prognosis, influencing factors