背景：儿童社区获得性肺炎（CAP）仍然是全世界儿童发病和死亡的主要原因之一。通过确定与复杂CAP（CCAP）发展相关的风险因素，可以确定早期诊断和有效治疗的新方法。
方法：这项回顾性队列研究纳入了2017年1月1日至2017年12月31日在研究医院儿科病房就诊的CAP和CCAP患者。对于CCAP患者，有关执行的医疗程序的数据，手术干预,收集住院时间。
结果：总共111名患者，93（83.7%）的CAP和18（16.3%）的CCAP，年龄在3个月至18岁之间的患者因重症肺炎住院。患者的平均年龄为3.6±1.2岁，其中60名（54％）为女性。CCAP患者的平均年龄高于CAP患者（4.2±3.3vs.分别为2.8±2.1年)；然而，差异无显著性(p=0.012)。CCAP患者的C反应蛋白水平明显高于CAP患者（10.06±7.55vs.分别为4.43±3.37g/L；p=0.007）。入院时缺氧在CCAP组比CAP组更为常见(p<0.001)。
结论：与缺氧有关的发现，呼吸窘迫,影像学上的胸腔积液是与CAP住院患者并发症发生相关的重要鉴别因素。因此,CCAP病因,诊断,应建立治疗方法并采取保护措施。
BACKGROUND: Community-acquired pneumonia (CAP) in children continues to be one of the prominent causes of pediatric morbidity and mortality worldwide. By determining the risk factors associated with the development of complicated CAP (CCAP), new approaches for early diagnosis and effective treatment can be identified.
METHODS: This retrospective cohort study enrolled patients with CAP and CCAP who visited the pediatric ward of the study hospital between January 1, 2017 and December 31, 2017. For patients with CCAP, data regarding medical procedures performed, surgical intervention, and hospitalization duration were collected.
RESULTS: A total of 111 patients, 93 (83.7%) with CAP and 18 (16.3%) with CCAP, aged between 3 months and 18 years were hospitalized because of severe pneumonia. The mean age of the patients was 3.6 ± 1.2 years and 60 (54%) of them were female. The mean age of patients with CCAP was higher than that of patients with CAP (4.2 ± 3.3 vs. 2.8 ± 2.1 years respectively); however, the difference was not significant (p = 0.012). Patients with CCAP exhibited a significantly higher C-reactive protein level than those with CAP (10.06 ± 7.55 vs. 4.43 ± 3.37 g/L respectively; p = 0.007). Hypoxia upon admission was noted more commonly in the CCAP group than in the CAP group (p < 0.001).
CONCLUSIONS: Findings related to hypoxia, respiratory distress, and pleural effusion on imaging are important distinguishing factors associated with the development of complications in patients hospitalized with CAP. Therefore, CCAP etiology, diagnosis, and treatment approaches should be established and protective measures adopted.
