| 摘要: |
| 目的：比较不同载量人博卡病毒（HBoV）肺炎患儿的临床特征及肺功能指标，了解HBoV载量与疾病的关系，探讨HBoV致病机制。方法：选取2013年1月至2013年11月因支气管肺炎在苏州大学儿童医院呼吸科住院治疗的婴幼儿1 653例，应用荧光定量PCR法检测患儿痰液中HBoV-DNA，检出HBoV阳性患儿122例，高载量组65例，低载量组57例，比较两组的临床特征；采用德国耶格MasterScope肺功能仪对HBoV阳性的64例婴幼儿（根据HBoV载量高低分组）进行肺功能检测，观测患儿潮气呼吸流速容量环形态及其各项指标变化。结果：不同HBoV载量感染组间临床症状比较,除喘息外，其他症状发生率差异均无统计学意义。但肺功能比较，高载量组与低载量组到达峰流速时间（TPTEF）、到达峰流速时呼出气量（VPTEF）及反映小气道功能指标到达峰流速时间/呼气时间（TPTEF/TE）、到达峰流速时呼出气量/呼气容积（VPTEF/VE）、剩余25%潮气量时呼气流速（TEF25%）及剩余25%潮气量时的呼气流速/呼气峰速（25/PF）均明显降低，且高载量组上述值下降更明显，两组比较差异有统计学意义（P<0.05）；高、低病毒载量组中代表大气道功能的指标平均呼气流速/平均吸气流速比（ME/MI）与正常对照组比较差异均无统计学意义。从TBFV环形态上看，HBoV肺炎患儿呼气峰左移，呼气相降支呈波谷样凹陷，且高载量组凹陷更加明显。结论：苏州地区HBoV肺炎住院婴幼儿存在一定肺功能的损害，主要表现为小气道阻塞性功能障碍。病毒载量与临床症状及肺功能损害程度相关，高载量组喘息发作率高，小气道损害明显。 |
| 关键词: 婴幼儿 人博卡病毒 病毒载量 潮气呼吸肺功能 支气管肺炎 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.06.001 |
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| 基金项目:江苏省社会发展项目，编号BE2012652。 |
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| Comparative Analysis of Clinical Characteristics and Pulmonary Function of Patients with Different viral Pneumonia in Children with Boka Virus |
| Chen Ying, Liu Weidong, Zhang Guiqin, Yin Fang, Li Ling, Wang Meijuan, Yan Yongdong, Xu Hong, Gu Guoying, Ji Wei |
| (1. Children's Hospital Affiliated to Suzhou University, Jiangsu Suzhou 215003, China; 2. Yancheng Maternal and Child Health Care Center, Jiangsu Yancheng 224002, China) |
| Abstract: |
| Objective: To discuss the pulmonary function changes in infants with community--acquired pneumonia due to high or low viral load of human bocavirus infection and its clinical significance. Methods: Applying quantitative real time PCR method to detecting HBoV-DNA in sputum.Retrospective analysis of the illness symptoms in 122 infant who had HBoV detected. Observe the shape of tidal breathing flow--volume loops and changes of every index.TBFVLs were obtained for 64 infants at admission with a Pulmonary Testing System (Jaeger MasterScope). Results: A high incidence of asthma relating to infant with pneumonia due to high viral load of HBoV, during acute phase of HBoV infection with high or low viral load,wave crest of TBFVLs moves left and the declined limb became trough-like concave, TPTEF, VPTEF, TEF25%, TPTEF/TE, VPTEF/VE, the ratio of TEF25% to PTEF were significantly decreased as compared with those in healthy infants. But ME/MI showed no significant difference. The index responding to small airway function, such as TEF25%, TPTEF/TE, the ratio of TEF25% to PTEF and VPTEF/VE were decreased more obviously in infants with high viral load. Coclusion: Whatever the hospitalized infants infected with high or low viral load of HBoV in suzhou, their lung function damages were dysfunction of small airway obstruction. More severe impairment of pulmonary function and higer incidence of wheezing in infants who were infected with the high viral load of HBoV. |
| Key words: Infant Human bocavirus Viral load Pulmonary function Pneumonia |
