| 摘要: |
| 目的：探讨呼吸道合胞病毒（RSV）和人类偏肺病毒（hMPV）所致婴幼儿急性毛细支气管炎的临床表现、住院时间、肺功能的差异。方法：收集苏州大学附属儿童医院2011-2012年收治住院的急性呼吸道感染患儿，无菌负压吸引法吸取新鲜痰液1~2 mL，采用直接免疫荧光法（DFA）检测常见病毒抗原，逆转录-聚合酶链反应（RT-PCR）扩增hMPV的N基因，以明确诊断。选取其中RSV急性毛细支气管炎155例（RSV组）、hMPV急性毛细支气管炎46例（hMPV组）进行临床分析，对部分RSV（50例）、hMPV（31例）感染患儿进行肺功能检测，并选取同龄健康儿童49例作为正常对照组。结果：确诊为儿童急性毛细支气管炎的住院患儿共计653例，其中RSV感染占23.74%（155/653），hMPV感染占7.04%（46/653），二者主要临床表现均为低氧血症、发热、咳嗽、喘息、鼻塞流涕、气促，但hMPV组低氧血症、发热、喘息、气促的发生率比RSV组低，住院时间比RSV组短（P均<0.05）。RSV和hMPV急性毛细支气管炎患儿肺功能均有不同程度受损，主要表现为小气道功能障碍，但两组肺功能各指标比较差异均无统计学意义（P均>0.05）。结论：hMPV和RSV一样是儿童急性毛细支气管炎常见病原之一。RSV、hMPV急性毛细支气管炎患儿临床表现、肺功能相似，但后者症状较轻、住院时间较短。潮气呼吸肺功能检测有利于评估RSV、hMPV感染后肺功能损害程度，可为临床诊治提供客观依据。 |
| 关键词: 婴幼儿 呼吸道合胞病毒 人类偏肺病毒 急性 毛细支气管炎 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.01.009 |
|
| 基金项目: |
|
| Clinical Analysis of Respiratory Syncytial Virus and Human Metapneumovirus to Children with Acute Bronchiolitis |
| Yang Tao1, Chen Zhengrong2 |
| (1. The Fifth People’s Hospital of Chengdu, Sichuan Chengdu 611130, China; 2. Children’s Hospital Affiliated to Suzhou University, Jiangsu Suzhou 215003, China) |
| Abstract: |
| Objective: To discuss the clinical manifestation and pulmonary function of infants with respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) bronchiolitis. Methods: The patients admitted with acute respiratory tract infection from 2011.01 to 2012.12 were enrolled in Children’s Hospital Affiliated to Suzhou University, and 2 milliliters fresh sputum was adopted using vacuum aspiration. RSV antigen was detected by direct immunofluorescence assay. At the mean time, N gene sequence of hMPV was amplified by reverse transcriptase polymerase chain reaction. Pulmonary function parameters with part of patients were obtained by tidal breathing analysis. Results: The incidence of RSV infection was 23.7 percent in-patient comparing with 7.0 percent of hMPV infection. The prevalence peaks of such two pathogens were superimposed, winter and spring were the predilection seasons. Frequency of fever, wheezing and tachypnea in patients with hMPV bronchiolitis was fewer than those of patients with RSV infection. The pulmonary function of all patients with RSV or hMPV bronchiolitis was damaged to some extent, and the parameters represented for small airway function were lower or higher than those of healthy controls, but there was no significant difference in patients with hMPV infection than these of RSV infection. Conclusion: hMPV was a common pathogen in respiratory tract infection. Both of the pathogens have the similar clinical manifestation and the hMPV infection is milder. The tidal breathing analysis is useful for evaluating the damage of pulmonary function and could provide objective evidence for clinic diagnosis and theraphy. |
| Key words: Infants Respiratory syncytial virus Human metapneumovirus Acute Bronchiolitis |
