摘要
目的分析呼吸道合胞病毒(respiratory syncytial virus,RSV)在儿童急性呼吸道感染中的临床特征,为及早做好预防措施和对症治疗提供理论和实践依据。方法选取银川市妇幼保健院2017年11月至2018年11月因急性呼吸道感染就诊治疗的765例患儿为研究对象,采集患儿上呼吸道分泌物,用多重聚合酶连锁反应(polymerase chain reaction,PCR)法及核酸电泳分别检测样本的多种病毒感染情况,结合患儿的临床资料,从发病年龄、临床症状、实验室指标、病毒共感染及细菌共感染情况等多方面分析RSV感染的临床特征。结果 765例标本中共检出RSV阳性标本204例,阳性检出率为26.7%,不同性别间RSV检出率差异无统计学意义(P>0.05);RSV感染组住院天数长于非RSV感染组(P<0.05);RSV感染主要发生在2岁以下婴幼儿(占55.9%);与非RSV感染组相比,RSV感染组发热症状严重(P<0.01),而咳嗽、喘憋、咽部充血、有无喘鸣音、肺部啰音、呼吸困难的临床症状差异均无统计学意义(P均>0.05)。实验室指标分析中,RSV感染者与非RSV感染者白细胞计数、血红蛋白、乳酸脱氢酶含量、谷草转氨酶、谷丙转氨酶含量差异均无统计学意义(P均>0.05)。204例RSV阳性标本中,42例(20.6%)为RSV单独感染,117例(57.4%)至少混合一种其他呼吸道病毒感染,41例(20.1%)既混合细菌感染又混合其他病毒感染,4例(2.0%)混合其他细菌感染;与RSV发生混合感染的病毒以鼻病毒常见(58.2%),混合感染的细菌以大肠埃希菌(24.4%)、肺炎克雷伯杆菌(22.2%)、金黄色葡萄球菌(15.6%)常见。RSV与其他病毒混合感染后,更易发生咳嗽,血红蛋白指标升高(P均<0.05);RSV与细菌混合感染后,更易出现肺部啰音,呼吸频率加快,谷草转氨酶升高(P均<0.05)。结论 RSV是婴幼儿急性呼吸道感染的重要病原体,临床症状主要有咳嗽、发热,常与其他病毒、细菌发生混合感染,需要通过预防和隔离来避免交叉�
Objective To analysis clinical features of respiratory syncytial virus(RSV)in children with acute respiratory infections and and to provide theoretical and practical basis for early prevention and symptomatic treatment. Methods A total of 765 children with acute respiratory infection who were hospitalized in the Maternal and Child Health Hospital of Yinchuan City from November 2017 to November 2018 were enrolled.The upper respiratory secretions of 765 children were collected. RNAs were extracted from the samples and transcribed to c DNA. Multiplex PCR and Nucleic acid electrophoresis were used to detect virus infection in 765 samples.Combining with the clinical records of each child,the epidemiological characteristics of RSV were analyzed by SPSS 22.0,including the age of onset,clinical symptoms,co-infection with other viruses,co-infection with bacteria and other aspects. Results A total of 204 RSV-positive specimens were detected in765 specimens. There was no significant difference in RSV detection rate between different genders(P>0.05).The length of hospital stay in RSV-infected group was longer than that in non-RSV infected group(P<0.05).RSV infection mainly occurs in infants and young children under 2 years of age(55.9%). Compared with non-RSV infection group,the RSV infection group had severe fever symptom(P<0.01),but there was no significant difference in symptoms such as cough,dyspnea,pharyngeal congestion,wheezing,rales and dyspnea(P>0.05).In the analysis of clinical indicators,white blood cell count,hemoglobin,lactate dehydrogenase content and other indicators were not specific,the difference was not statistically significant(P>0.05). In 204 cases of RSV infection,42 cases(20.6%)were RSV infection alone,117 cases(57.4%)were co-infection with at least one respiratory virus infection,41(20.1%)were co-infection with bacteria and other virus,and 4 cases(2.0%)were co-infection with bacteria. The most common virus involved in the mixed RSV infections was rotavirus(58.2%). The most common bacteria involved in t
作者
张淋然
闫琰
季凯
韩磊
郝雪琦
李芳
孙玉宁
ZHANG Linran;YAN Yan;JI Kai;HAN Lei;HAO Xueqi;LI Fang;SUN Yuning(Department of Biochemistry and Molecular Biology,School of Basic Medicine,Ningxia Medical University,Yinchuan750004,China;Yinchuan Maternal and Child Health Hospital,Yinchuan750001,China;Department of Respiratory and Critical Medicine,the General Hospital of Ningxia Medical University,Yinchuan750004,China)
出处
《宁夏医科大学学报》
2020年第6期573-579,共7页
Journal of Ningxia Medical University
基金
国家自然科学基金(81560340,31760041)
宁夏回族自治区自然科学基金(NZ15061)。
关键词
呼吸道合胞病毒
呼吸道感染
儿童
临床症状
respiratory syncytial virus
respiratory infections
children
clinical symptoms
