儿童下呼吸道感染与哮喘加重的相关性研究  

The relationship between the lower respiratory viral infection and allergen sensitization in exacerbating asthma in children

作　　者：丁蓉 朱群[2] 陈建斌[3] 

机构地区：[1]江苏省妇幼保健院儿科,南京210014 [2]南京市中西医结合医院内科,南京210014 [3]南京市儿童医院外科,南京210000

出　　处：《中国医学前沿杂志（电子版）》2014年第12期80-83,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨儿童下呼吸道病毒感染、特应性和哮喘加重之间的关系。方法收集2011年1月至2013年1月本院收治的619例急性下呼吸道感染患儿,根据临床表现和放射检查分别诊断为肺炎、支气管炎、细支气管炎和哮喘急性发作,并按该诊断分为四组。检测呼吸道合胞病毒、鼻病毒、腺病毒、流感病毒、副流感病毒RNA及外周血嗜酸性粒细胞和免疫球蛋白E(Ig E),特应性以Ig E≥0.35IU/ml作为诊断标准,比较组间差异,并以Logistic回归方法分析病毒感染与哮喘急性加重的关系以及特应性与病毒感染的关系。结果鼻病毒感染(P=0.022)和流感病毒感染(P=0.026)均显著多见于哮喘,同时流感病毒感染在支气管炎组患儿中阳性检测率显著升高(P=0.011)。哮喘组患儿外周血嗜酸性粒细胞计数和血清Ig E明显高于其他三组(P=0.000)。结论特应性参与鼻病毒或流感病毒诱发的儿童哮喘的急性加重。Objective To investigate the prevalence of year-round respiratory viral infection in children with lower respiratory tract infection（LRTI） and the relationship between respiratory viral infection and allergen sensitization in exacerbating asthma. Method Investigated the sources for acute LRTIs in children admitted to our hospital from January 2011 to January 2013. According to the diagnosis, the enrolled 618 children were divided into 4 groups： pneumonia, bronchitis, bronchiolitis and asthma. The 5 most common respiratory viruses were isolated from nasopharyngeal aspirate using reverse transcription-polymerase chain reaction; respiratorysyncytial virus（RSV）, adenovirus（AV）, parainfluenza virus（PIV）, influenza virus（IFV）, and rhinovirus（RV）. Atopic sensitization was defined if IgE ≥ 0.35 IU/ml. Result RV or IFV infection was more prevalent in asthma exacerbations compared to other LRTIs. AV was more likely to cause pneumonia. RV and IFV were associated with asthma exacerbations in children with atopic sensitization, but not in nonatopic children. Conclusion RV and IFV are associated with hospitalization for asthma exacerbation in children with atopic sensitization.

关 键 词：下呼吸道感染 哮喘 病毒 特应性 

分 类 号：R725.6[医药卫生—儿科]