儿科重症监护室喘息性疾病的病毒性病原学研究  

Study of viral etiology in children with wheezing disease in Pediatric Intensive Care Unit

作　　者：林创兴[1] 陆学东[2] 林广裕[1] 蔡志伟[1] 蔡晓莹[1] 陈洁玲[1] 周晓华[1] 陈派镇[1] 

机构地区：[1]汕头大学医学院第二附属医院儿科,515041 [2]深圳市第四人民医院检验科

出　　处：《中华实用儿科临床杂志》2014年第22期1708-1710,共3页Chinese Journal of Applied Clinical Pediatrics

基　　金：广东省卫生厅医学科研基金项目（B2012256）

摘　　要：目的 了解儿科重症监护室中喘息性疾病的病毒性病原谱。方法 收集2010年6月至2011年12月因喘息性疾病入住汕头大学医学院第二附属医院儿科重症监护室患儿咽拭子标本70份。应用多重 PCR技术对呼吸道病毒进行检测，并分析阳性病例的临床资料。结果 70份咽拭子标本中，呼吸道病毒检测阳性54例（77%），其中单独病毒阳性34例，混合感染20例。病毒检测阳性标本中，最常见的是呼吸道合胞病毒（RSV）23份，其次分别是人鼻病毒（HRV）21份，腺病毒8份，人博卡病毒4份，副流感病毒3型4份，副流感病毒4型3份，人偏肺病毒、W U多瘤病毒、季节性流感H1N1和新型甲型流感H1N1各1份；混合感染中19份为2种病毒混合，1份为3种病毒混合；混合检出最多的病毒是 RSV 混合 HRV（6份）。病毒检测阳性标本中，临床诊断39例喘息性肺炎，11例毛细支气管炎，3例喘息性支气管炎和1例支气管哮喘持续状态。结论 本地区儿科重症监护室中喘息性疾病的病原体中病毒性病原体检出率高，以RSV和HRV最常见。Objective To investigate the viral pathogen spectrums in children with wheezing disease in Pedia- tric Intensive Care Unit （PICU）. Methods Nasopharyngeai aspirates specimens （NPA） specimens were collected from 70 children with wheezing disease who were admitted to PICU in the Second Affiliated Hospital of Shantou University Medical College from Jan. 2010 to Dec. 2011. Multiplex PCR was applied to detect the respiratory viruses, the clinical data of the positive cases were analyzed. Results Seventy throat swab specimens tested positive in 54 cases of respira- tory viruses （77%）, of which a single virus-positive in 34 cases,20 cases of mixed infection. For the specimens tested positive for the virus, the most common was respiratory syncytial virus （ RSV）, and there were 23 copies of them, fol- lowed by the human rhinovirus （HRV） 21 copies, adenovirus 8 copies, human Bocavirus 4 copies ,4 copies with parain- fluenza virus type 3,3 copies with parainfluenza virus type 4, there were 1 copy positive for human metapneumovirus, 1 copy positive for WU polyomavirus, 1 copy positive for seasonal flu and 1 copy positive for swine HI N1. Mixed infection in 19 copies with 2 kinds of viruses mixed, 1 copy with 3 kinds of viruses mixed, and hybrid virus was detected in most RSV mixed HRV （6 copies）. For the specimens tested positive for the virus, their clinical diagnosis：39 cases of asth- matic pneumonia, 11 cases of bronchiolitis,3 cases of asthmatic bronchitis and 1 case of status asthmaticus. Conelu- slons There was a high rate of detection of viral pathogens in children with wheezing disease in PICU in the Second Affiliated Hospital of Shantou University Medical College, and the most common viruses were respiratory syncytial virus and rhinovirus.

关 键 词：呼吸道感染 儿科重症监护室 儿童 鼻病毒 呼吸道合胞病毒 

分 类 号：R725.6[医药卫生—儿科]