呼吸道合胞病毒与非合胞病毒感染毛细支气管炎临床特征比较  

Clinical characteristics of children with respiratory syncytial virus bronchiolitis versus non - respiratory syncytiai virus bronchiolitis

作　　者：孙亚林[1] 孙慧明[1] 刘继贤[1] 

机构地区：[1]苏州大学附属儿童医院呼吸科,215003

出　　处：《中华实用儿科临床杂志》2016年第16期1238-1241,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的探讨呼吸道合胞病毒（RSV）与非合胞病毒（Non—RSV）感染毛细支气管炎临床特征的差异。方法收集2012年1月至2013年12月因毛细支气管炎入住苏州大学附属儿童医院且病史资料完整的患儿541例，采集下呼吸道分泌物进行RSV及其他病原菌检测，应用PASW21．0软件对RSV毛细支气管炎患儿（RSV组）与Non-RSV毛细支气管炎患儿（Non-RSV组）临床特征进行比较。结果1．194例（36％）患儿纳入RSV组，347例（64％）纳入Non—RSV组；2．每年12月份至次年2月份RSV感染较Non．RSV感染的毛细支气管炎常见，5至10月份Non—RSV较RSV感染的毛细支气管炎常见；3．与Non．RSV组比较，RSV组患儿的年龄小（Z=5．62，P〈0．001），易发生发绀（X2=9．02，P=0．003），且住院天数、住院费用、吸氧比例、吸氧天数、入ICU比率、ICU住院天数及机械通气天数均高于Non—RSV组，差异均有统计学意义（P均〈0．05）；白细胞计数、中性粒细胞比例及CRP水平均低于Non—RSV组，淋巴细胞比例、血小板及ALT水平均高于Non-RSV组，差异均有统计学意义（P均〈0．05）。结论RSV引起的毛细支气管炎与非合胞病毒感染的患儿相比，其年龄小，临床症状重，易发生发绀及呼吸衰竭，应引起临床医师的重视。Objective To study the difference in clinical characteristics between respiratory syncytial virus （RSV） bronchiolitis and non - RSV bronchiolitis. Methods A retrospective review of the medical records of 541 children with bronchiolitis in Children＇s Hospital of Soochow University between January 2012 and December 2013 was conducted. The secretions of the lower respiratory tract were collected to detect RSV and other pathogens, the clinical characteristics between the 2 teams were analyzed by using PASW 21.0 software. Results （ 1 ）There were 194 patients （36%） hospitalized for bronchiolitis,who were assigned as RSV group, and 347 patients （64%） were assigned as non - RSV group. （2） Bronchiolitis due to RSV was more common from December to February, and bronchiolitis due to non - RSV was more common from May to October. （ 3 ） Compared with non - RSV group, RSV bronchiolitis started from a younger age （ Z = 5.62, P 〈 0.001 ）, pron to cyanosis （x^2 = 9.02, P = 0.003 ） ,longer hospital stays, more expensive cost, more oxygen use, longer days of oxygen, ICU and mechanical ventilation, higher risk of ICU admission, higher the percentage of lymphocyte and platelet, the differences between 2 types were statistically significant （ all P 〈 0.05 ）. White blood cell（WBC） count, neutrophils proportion and C -reactive protein（CRP） was higher in non -RSV than RSV bronchiolitis, the levels of lymphocyte, blood platelet and alanine aminotransferase （ALT） were higher in RSV than non - RSV bronchiolitis, the differences were statistically significant （ all P 〈 0.05 ）. Conclusions Compared with non - RSV group,so RSV bronchiolitis is much more severe,and the patients need longer hospital stays and more expensive cost. Clinicians should pay close attention to RSV bronchiolitis.

关 键 词：呼吸道合胞病毒 非呼吸道合胞病毒 毛细支气管炎 

分 类 号：R725.6[医药卫生—儿科]