| 摘要: |
| 目的:总结人博卡病毒(HBoV)感染导致塑型性支气管炎(PB)的临床特征,为诊疗提供参考。方法:回顾2 例经靶向下
一代测序(tNGS)确诊的HBoV-PB 患儿资料,并系统检索CNKI、万方、维普、PubMed、Google Scholar 和Web of Science 数据库,归
纳临床表现、影像特点、病原检测、治疗及转归等。结果:2 例患儿均以发热、咳嗽起病,其中1 例伴喘息、气促,对常规抗感染、
雾化及祛痰治疗无效。胸部影像示肺不张和/ 或实变,气管镜提示PB,tNGS 检测到HBoV。共纳入文献11 篇,包括32 例HBoVPB
患儿,男女比例3. 57 ∶ 1,年龄10 个月~5 岁,18. 8%有过敏史。主要表现为发热、咳嗽、气促、喘息和进行性呼吸困难;单一
HBoV 感染占81. 3%。32 例均行胸片/ CT,78. 1%见肺不张,43. 8%见实变,12. 5%见支气管狭窄或闭塞;16 例病理显示纤维蛋
白伴嗜酸粒细胞浸润,3 例有夏科-雷登晶体。所有患儿预后良好,无并发症。结论:婴幼儿若出现发热、咳嗽、重度喘息及进行
性呼吸困难,且CT 提示肺不张或气道黏液栓,应警惕HBoV-PB。tNGS 有助于明确病原,支气管镜对诊疗至关重要。 |
| 关键词: 塑型性支气管炎 儿童 人博卡病毒 靶向下一代测序 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2025.06.010 |
|
| 基金项目:2023 年四川省自然科学基金(青年基金项目),编号2023NSFSC1469。 |
|
| Plastic Bronchitis Reduced by Human Bocavirus Infection: Two Case Reports and Literature Review |
| Chen Hongjia, Xia Wanmin, Huang Yijie |
| (The Affiliated Women’s and Children’s Hospital, School of Medicine, University of
Electronic Science and Technology of China, Chengdu Women’s and Children’s Central Hospital, Chengdu 611731, China) |
| Abstract: |
| Objective: To summarize the clinical characteristics of plastic bronchitis (PB) induced by human bocavirus (HBoV)
infection, and provide guidance for diagnosis and treatment. Methods: Clinical data of 2 children with HBoV-PB diagnosed by targeted
next-generation sequencing (tNGS) were reviewed, and literature from CNKI, Wanfang, VIP, PubMed, Google Scholar and Web of
Science databases were systematically retrieved to summarize the clinical manifestations, imaging characteristics, pathogen detection,
treatment and prognosis. Results: Both cases presented with fever and cough, one case had wheezing and dyspnea, standard antibiotics,
nebulization, and expectorants failed. Imaging showed atelectasis and/ or consolidation, bronchoscopy confirmed PB, tNGS identified
HBoV. A total of 11 articles were enrolled, and 32 cases of HBoV-PB were reported. The ratio of male to female was 3. 57 ∶ 1. The age
ranged from 10 months to 5 years, and 18. 8% had a history of allergy. The main manifestations were fever, cough, dyspnea, wheezing
and progressive respiratory distress, isolated HBoV infection accounted for 81. 3%. Chest X-rays/ CT were performed in 32 cases. And
78. 1% showed atelectasis, 43. 8% showed consolidation, and 12. 5% showed bronchial obstruction or stenosis. The pathology of 16
cases showed fibrin with eosinophil infiltration, and 3 cases had Charcot-Reden crystals. All patients had good prognosis and no
complications. Conclusion: For infants with fever, cough, severe wheezing and progressive respiratory distress, and CT indicates
atelectasis or airway mucus plugs, HBoV-PB should be vigilant. tNGS is helpful for pathogen identification, and bronchoscopy is crucial
for diagnosis and treatment. |
| Key words: plastic bronchitis children human bocavirus targeted next-generation sequencing |
