哮喘急性发作与呼吸道感染的关系  

Relationship between Acute Exacerbation of Asthma and Respiratory Tract Infections in Children

作　　者：徐慧香[1] 张慧燕[1] 车大钿[1] 陆敏[1] 

机构地区：[1]上海交通大学附属儿童医院呼吸科,上海200040

出　　处：《实用儿科临床杂志》2007年第4期271-272,276,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨哮喘急性发作与呼吸道病毒及肺炎支原体(MP)、肺炎衣原体(CP)感染的关系。方法哮喘急性发作期患儿74例鼻咽分泌物采用直接免疫荧光法检测呼吸道合胞病毒(RSV),腺病毒(AdV),流感病毒A、B(IFVA、IFVB)型,副流感病毒Ⅰ、Ⅱ、Ⅲ(PFVⅠ、PFVⅡ、PFVⅢ)型7种病毒抗原。并采外周静脉血,用颗粒凝集法检测血清MP-IgM抗体,间接固相酶免疫法检测患儿血清CP-IgM抗体。结果明确感染病原诊断者29例(39.2%)。婴幼儿组病原学阳性14例(43.8%),其中RSV6例(18.8%)居首位;其次PFVⅢ4例(12.5%);MP占6.25%;AdV及CP各占3.1%。学龄前及学龄组病原学阳性15例(35.7%),其中MP 9例(21.4%),居首位;其次CP 3例(7.1%);而PFVⅢ和RSV仅占4.8%和2.4%。婴幼儿组与学龄前及学龄组间呼吸道病毒感染、非典型微生物(CP和MP)感染率差异均有显著意义(Pa<0.05)。结论哮喘急性发作与呼吸道感染关系密切,婴幼儿哮喘与呼吸道病毒感染关系紧密,而非典型微生物感染可能是学龄前及学龄期儿童哮喘急性发作的重要诱因。Objective To explore the relationship between asthma exacerbation and respiratory tract infections of viruses,Mycoplasma pneumoniae（MP）,Chlamydia pneumoniae（CP）in children.Methods Seven viruses including respiratory syncytial virus（RSV）,adenovirus（AdV）,influenza virus A（IFVA）,influenza virus B（IFVB） and parainfluenza virus Ⅰ,Ⅱ,Ⅲ（PFVⅠ,Ⅱ,Ⅲ） from the nasopharyngeal aspirate of 74 patients with asthma were rapidly diagnosed by direct immunofluorescence assay,as well as the serum MP-IgM,CP-IgM were detected by the granule agglutinating method and indirect solid-phase enzyme immunoassay（EIA）,respectively.Results Pathogens were detected in 29 out of 74 cases（39.2%） with asthma exacerbation.Of whom 14 cases（43.8%） were in infant and another 15 cases（18.8%） were in preschool and school children.RSV was the leading pathogen in infant,it was discovered in 6 cases（accounting for 18.8%）.The se-cond pathogen was PFVⅢ which was discovered in 4 cases（12.5%）.MP,AdV and CP accounted for 6.25%,3.1%,3.1%,respectively.But in preschool and school children,MP was the most common pathogen which were discovered in 9 cases（21.4%）,the following pathogen was CP which was discovered in 3 cases（7.1%）,PFVⅢ and RSV only accounted for 4.8%,2.4%,respectively.There was significant differences statistically between two groups in viral respiratory tract and atypical-microorganism infections rate（Pa〈0.05）.Conclusions Asthma exacerbation in children is related closely to respiratory tract infections.In infant,asthma exacerbation is linked closely to the viral respiratory tract infections,but in preschool and school children,it is related to MP and CP infections.

关 键 词：哮喘 呼吸道感染 病毒 非典型微生物 儿童 

分 类 号：R725.6[医药卫生—儿科]