2025 年第 1 期 第 0 卷

妊娠合并流感患者危重症的影响因素及妊娠结局分析

Analysis of the influencing factors of critically ill and pregnancy outcomes of pregnant patients with influenza

作者：李玫蓉  王力川  施剑英  王舒婷  陈锐

英文作者：Li Meirong Wang Lichuan Shi Jianying Wang Shuting Chen Rui

单位：广西壮族自治区妇幼保健院急诊科，南宁530000

英文单位：Department of Emergency Maternal and Child Health Care of Guangxi Zhuang Autonomous Region Nanning 530000

关键词：妊娠；  流感；  临床特征；  高危因素；  妊娠结局

英文关键词：Pregnancy;  Influenza;  Clinicalfeatures;  Highriskfactors;  Pregnancyoutcome

• 摘要：

• 目的  分析妊娠合并流感患者危重症的影响因素及妊娠结局。方法  选取广西壮族自治区妇幼保健院2022年1月至2023年12月121例妊娠合并流感患者作为观察对象。根据患者疾病的严重程度分为普通组（64例）和危重组（57例）。单因素和多因素Logistic回归方法分析影响妊娠合并流感危重症的影响因素。统计并分析患者妊娠结局情况。结果  2组是否接种疫苗、呼吸症状是否严重、淋巴细胞计数、C反应蛋白（CRP）、乳酸脱氢酶（LDH）水平差异均有统计学意义（均P<0.05）。多因素Logistic回归分析结果显示未接种疫苗（比值比=3.105，95%置信区间：1.345～7.170）、呼吸症状严重（比值比=2.085，95%置信区间：1.098～3.958）、CRP水平高（比值比=4.011，95%置信区间：1.572～10.236）、LDH水平高（比值比=1.806，95%置信区间：1.131～2.885）是妊娠合并流感患者危重症的危险因素，淋巴细胞水平高（比值比=0.894，95%置信区间：0.831～0.961）是妊娠合并流感患者危重症的保护因素（均P＜0.05）。危重组患者均在流感住院期间妊娠终止，2组新生儿均未发生先天畸形。危重组早产率和足月产率均高于普通组［61.4%（35/57）比4.7%（3/64）、29.8%（17/57）比9.4%（6/64）］，继续妊娠率低于普通组［0（0）比82.8%（53/64）］（均P＜0.05）。结论  流感严重程度会对患者的妊娠结局造成影响，是否接种疫苗、呼吸症状是否严重、淋巴细胞计数、CRP、LDH水平均为影响妊娠合并流感患者危重症的因素，应及时采取有效措施，避免危重症的发生。

• Objective  To analyze the influencing factors of critically ill and pregnancy outcomes of pregnant patients with influenza. Methods   A total of 121 pregnant women with influenza in Maternal and Child Health Care of Guangxi Zhuang Autonomous Region from January 2022 to December 2023 were selected as the observation objects. According to the severity of the disease, the patients were divided into general group (64 cases) and critical group (57 cases). Univariate and multivariate Logistic regression methods were used to analyze the influencing factors of critical illness during pregnancy with influenza. The pregnancy outcomes of the patients were counted and analyzed. Results   There were statistically significant differences between the two groups in whether they were vaccinated, whether they had severe respiratory symptoms, lymphocyte count, C-reactive protein (CRP) and lactate dehydrogenase (LDH) levels (all P<0.05). The results of multivariate Logistic regression analysis showed that unvaccinated ［odds ratio(OR)=3.105, 95% confidence interval(CI): 1.345-7.170］, severe respiratory symptoms (OR=2.085, 95%CI:1.098-3.958), high CRP level (OR=4.011, 95%CI: 1.572-10.236) and high LDH level (OR=1.806, 95%CI: 1.131-2.885) were risk factors for critical illness in pregnant women with influenza, and high lymphocyte level (OR=0.894, 95%CI: 0.831-0.961) was a protective factor for critical illness in pregnant women with influenza (all P<0.05). All pregnancies in the critical group were terminated during hospitalization for influenza, and no congenital malformations were found in the neonates of the two groups. The preterm birth rate and full-term birth rate in the critical group were higher than those in the general group ［61.4%(35/57) vs 4.7%(3/64), 29.8%(17/57) vs 9.4%(6/64)］, and the continuing pregnancy rate was lower than that of the general group ［0(0) vs 82.8%(53/64)］(all P<0.05). Conclusion   The severity of influenza can affect the pregnancy outcome of patients. Vaccination, the severity of respiratory symptoms, lymphocyte count, CRP and LDH levels are all factors affecting the critical illness of pregnant patients with influenza. Effective measures should be taken in time to avoid the occurrence of critical illness.