婴儿新型冠状病毒与甲型流感病毒感染血常规及炎症标志物的对比

doi:10.3969/j.issn.1674-490X.2026.02.003

摘要/Abstract

摘要： 目的探讨婴儿患新型冠状病毒感染(corona virus disease 2019, COVID-19)与甲型流感病毒感染(influenza A virus infection, IAV)早期白细胞计数、中性粒细胞计数、淋巴细胞计数、血小板、C反应蛋白、血清淀粉样蛋白A、降钙素原及中性粒细胞/淋巴细胞比值的差异性。方法对2025年1月1日至3月31日北京京都儿童医院重症医学科收治的63例COVID-19患儿及同期收治的69例IAV患儿的血常规和炎症指标进行对比分析。结果白细胞计数,COVID-19患儿为(5.12±1.89)×10⁹·L^-1,低于IAV患儿(5.92±2.12)×10⁹·L^-1,差异有统计学意义(t=-2.291,P=0.016)。中性粒细胞计数,COVID-19患儿为2.30(1.62,3.43)×10⁹·L^-1,低于IAV患儿2.71(1.43,3.93)×10⁹·L^-1,差异有统计学意义(Z=-2.540,P=0.011)。中性粒细胞/淋巴细胞比值,COVID-19患儿为0.98(0.62,1.86),低于IAV患儿1.29(0.48,2.85),差异有统计学意义(Z=-2.882,P=0.004)。血小板,COVID-19患儿为(278.31±80.10)×10⁹·L^-1,高于IAV患儿(233.51±74.21)×10⁹·L^-1,差异有统计学意义(t=3.323,P<0.001)。 C反应蛋白,COVID-19患儿为4.23(0.50,7.72)mg·L^-1, 高于IAV患儿3.12(0.50,6.22)mg·L^-1,差异有统计学意义(Z=-2.002,P=0.045)。血清淀粉样蛋白A,COVID-19患儿为15.32(3.01,19.70)mg·L^-1,高于IAV患儿9.45(1.00,12.00)mg·L^-1,差异有统计学意义(Z=-2.649,P=0.008)。结论 COVID-19组的白细胞计数、中性粒细胞计数、中性粒细胞/淋巴细胞比值低于IAV 组;血小板计数、血清淀粉样蛋白A 及C反应蛋白高于IAV组。儿童COVID-19与IAV的外周血炎症及血小板相关指标存在特征性差异,白细胞、中性粒细胞及中性粒细胞/淋巴细胞比值升高伴血小板降低是IAV的实验室特点,可作为2种病毒感染临床鉴别诊断的重要实验室参考依据。

关键词: 婴幼儿, 呼吸道感染, 新型冠状病毒, 甲型流感病毒, 炎症标志物

Abstract: Objective To explore the differences in early blood routine indicators, including white blood cell count, neutrophil count, lymphocyte count, platelet count, C-reactive protein, serum amyloid A, procalcitonin, and neutrophil-to-lymphocyte ratio, between infants with novel coronavirus infection(COVID-19)and those with influenza A virus infection(IAV). Methods A comparative analysis was conducted on inflammatory blood indicators in 63 COVID-19 patients and 69 IAV patients admitted to Intensive Care Unit of Beijing Children's Hospital from January 1 to March 31, 2025. Results The white blood cell count in 63 children with COVID-19 was(5.12±1.89)×10⁹·L^-1, which was lower than that in 69 children with IAV(5.92±2.12)×10⁹·L^-1, with a statistically significant difference(t=-2.291,P=0.016). The neutrophil count in 63 children with COVID-19 was 2.30(1.62, 3.43)×10⁹·L^-1, which was lower than that in 69 children with IAV(2.71(1.43, 3.93)×10⁹·L^-1), with a statistically significant difference(Z=-2.540,P=0.011). The neutrophil-to-lymphocyte ratio in 63 children with COVID-19 was 0.98(0.62, 1.86)×10⁹·L^-1, which was lower than that in 69 children with IAV(1.29(0.48, 2.85)×10⁹·L^-1), with a statistically significant difference(Z=-2.882,P=0.004). The platelet count in 63 children with COVID-19 was(278.31±80.10)×10⁹·L^-1, which was higher than that in 69 children with IAV(233.51±74.21)×10⁹·L^-1, with a statistically significant difference(t=3.323,P<0.001). The C-reactive protein level in 63 children with COVID-19 was 4.23(0.50, 7.72)mg·L^-1, while that in 69 children with IAV was 3.12(0.50, 6.22)mg·L^-1, with statistically significant difference between the two groups(Z=-2.002, P=0.045). The serum amyloid A levels in 63 children with COVID-19 were 15.32(3.01, 19.70)mg·L^-1, while those in 69 children with IAV were 9.45(1.00, 12.00)mg·L^-1. There was statistically significant difference between the two groups(Z=-2.649, P=0.008). Conclusion The white blood cell count, neutrophil count, and neutrophil-to-lymphocyte ratio in the COVID-19 group are significantly lower than those in the IAV group. Platelet count, serum amyloid A, and C-reactive protein are significantly higher in the IAV group. There are characteristic differences in peripheral blood inflammation and platelet-related indicators between pediatric COVID-19 and IAV infections. Elevated white blood cell count, neutrophil count, and neutrophil-to-lymphocyte ratio accompanied by reduced platelet count are laboratory features of IAV infection and can serve as important laboratory references for clinical differential diagnosis between the two viral infections.

Key words: infants and young children, respiratory infections, SARS-CoV-2, influenza A virus, inflammatory markers

中图分类号:

杨梅,韩燕丽,陈心. 婴儿新型冠状病毒与甲型流感病毒感染血常规及炎症标志物的对比[J]. 医学研究与教育, 2026, 43(2): 20-25.

YANG Mei, HAN Yanli, CHEN Xin. Comparative study on blood routine test and inflamatory makers of COVID-19 and influenza A virus infection in infants[J]. Journal of Hebei Medical College for Continuing Education, 2026, 43(2): 20-25.

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