摘要
目的了解引起儿童哮喘急性发作的呼吸道病毒谱,探讨呼吸道病毒感染与儿童哮喘急性发作的相关性。方法选取2015年1月至2017年8月于广州医科大学附属第一医院住院的哮喘急性发作儿童114例和其中处于缓解期儿童18例。以荧光定量RT-PCR的方法对其进行包括呼吸道合胞病毒(RSV)、鼻病毒(RV)、腺病毒(ADV)、甲型流感病毒(IFA)、乙型流感病毒(IFB)、副流感病毒1-4型(HPIV1-4)、肠病毒(EV)、人偏肺病毒(hMPV)、博卡病毒(BOCA)的检测。得出引起儿童哮喘急性发作的呼吸道病毒谱。比较不同年龄、伴或不伴发热、急性发作程度轻、中、重各组之间病毒总阳性率和各病毒检出率的差异,分析呼吸道病毒感染与各分组间的关系。结果114例急性发作标本中共检出呼吸道病毒80例(70.2%),18例缓解期标本中共检出呼吸道病毒2例(11.1%),两组呼吸道病毒检出情况差异有统计学意义(P<0.05)。急性发作标本当中,RV感染45例(39.5%),RSV感染17例(14.9%),HPIV3感染12例(10.5%),其他病毒感染34例(29.8%),混合感染23例(20.2%),以RV+RSV混合感染最常见。0~3岁组RSV检出率为25.0%(9/36),高于≥3岁组的10.3%(8/78),差异有统计学意义(P<0.05)。发热组EV检出率为18.2%(6/33),高于无发热组的2.5%(2/81),差异有统计学意义(P<0.05)。病毒总阳性率(89.5%)和RSV检出率(36.8%)在哮喘急性发作中度组中最高,差异有统计学意义(P<0.05)。结论呼吸道病毒感染是儿童哮喘急性发作的重要诱发因素,RV是首要病原体,RSV会加剧哮喘发作的程度。临床需做好预防工作,防止诱发哮喘急性发作。
Objective To study the respiratory virus spectrum which cause acute asthma exacerbations in children and explore the association between them.Methods 114 cases of children with acute asthma exacerbations hospitalized in Guangzhou from January 2015 to August 2017 and 18 cases of children in remission were selected.RT-PCR methods were used to detect respiratory pathogen,including respiratory syncytial virus(RSV),rhinovirus(RV),adenovirus(ADV),influenza A(IFA),influenza B(IFB),parainfluenza virus 1-4(HPIV1-4),enterovirus(EV),human meta lung virus(hMPV)and Boka virus(BOCA).The respiratory virus spectrum causing acute asthma exacerbations in children was obtained.The association between respiratory virus infection and acute asthma exacerbations in children was explored by comparing the difference of total positive rate and virus detection rate among different age groups,with or without fever,and the severity of asthma.Results The total positive rate was 70.2%in the acute exacerbation group and 11.1%in the control group.In acute exacerbation group,45(39.5%)were infected with RV,17(14.9%)with RSV,12(10.5%)with HPIV3,34(29.8%)with other viruses,and 23(20.2%)with co-infection.The most common pattern of co-infection was RV co-infected with RSV.RSV detection rate in the age group 0~3(25.0%)was higher than that in the group aged 3 or above(10.3%).EV detection rate in fever group(18.2%)was higher than that in non-fever group(2.5%).The virus positive rate(89.5%)and RSV detection rate(36.8%)were the highest in the group with moderate asthma.Conclusions Respiratory virus infection was an important inducing factor of acute asthma in children.RV was the primary pathogen.RSV infection could aggravate the severity of acute asthma.
作者
刘长连
林勇平
徐韫健
陈德晖
林育能
LIU Zhang-lian;LIN Yong-ping;XU Yun-jian;CHEN De-hui;LIN Yu-neng(Laboratory Department of the First Affiliated Hospital of Guangzhou Medical College,Guangzhou,Guangdong 510120;Department of Pediatrics,the First Affiliated Hospital of Guangzhou Medical College,Guangzhou,Guangdong 510120,China)
出处
《热带医学杂志》
CAS
2019年第10期1197-1200,共4页
Journal of Tropical Medicine
基金
呼吸道新发突发及重大传染病综合防诊治(2014广州市重大专项)(201400000002).
关键词
呼吸道病毒
儿童哮喘
急性发作
Respiratory virus
Childhood asthma
Acute exacerbations
