儿童支气管哮喘呼吸道病毒感染及危险因素分析  

Respiratory virus infection and risk factors in children with bronchial asthma

作　　者：李立学[1] 王平康[1] 张祥[1] 陈雅祺 王涛[2] LI Li-xue;WANG Ping-kang;ZHANG Xiang;CHEN Ya-qi;WANG Tao(Department of Pediatrics,People′s Hospital of Jianyang City,Jianyang,Sichuan 641400,China;Department of Pediatric Cardiovascular Medicine,Huaxi Second Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川省简阳市人民医院儿科,四川简阳641400 [2]四川大学华西第二医院儿童心血管内科,四川成都610041

出　　处：《公共卫生与预防医学》2022年第3期154-156,共3页Journal of Public Health and Preventive Medicine

摘　　要：目的 了解儿童支气管哮喘呼吸道病毒感染病原学体征及危险因素,为支气管哮喘患儿防治呼吸道病毒感染提供理论依据。方法 选取简阳市人民医院2018年12月至2020年12月来该院就诊的支气管哮喘患儿374例,门诊患儿就诊当日采集咽拭子,住院患儿24 h内采用负压吸引器采集患者2mL鼻咽部分泌物,检测RSV、ADV、IVA、IVB、PIVI、PIV II、PIV III7项病毒抗原,根据病毒检测结果是否阳性分为试验组(n=191)和对照组(n=183),采用Logistic回归分析方法筛选支气管哮喘患儿发生呼吸道病毒感染的危险因素。结果 374份样本中病毒阳性率为51.07%(191/374),阳性标本中病毒种类构成比占前3位的分别为RSV占41.36%(79/191)、ADV占30.36%(58/191)和PIV III占9.42%(18/191)、IVA占5.24%(10/191)、PIV II占5.24%(10/191)、PIVI占3.66%(7/191)、IVB占1.57%(3/191)。男女患儿病毒检出率分别为47.96%(94/196)和54.49%(97/178),差异无统计学意义(χ^(2)=1.597,P>0.05);1~3岁患儿阳性检出率明显高于>3岁组(χ^(2)=6.412,P<0.05);两组间哮喘发作次数、静脉应用糖皮质激素及发病季节差异有统计学意义(P<0.05);结果显示哮喘发作次数>3次、静脉应用糖皮质激素、发病季节是支气管哮喘患儿发生呼吸道病毒感染的独立危险因素(P<0.05)。结论 哮喘患儿发生急性呼吸道感染时感染季节主要集中在秋冬季,以RSV为主要病毒病原,应针对哮喘发作次数>3次、静脉应用糖皮质激素的支气管哮喘患儿给予针对性预防措施,可降低哮喘患儿发生呼吸道病毒感染。Objective To understand the etiological characteristics and risk factors of respiratory virus infection in children with bronchial asthma, and to provide theoretical basis for the prevention and treatment of respiratory virus infection in children with bronchial asthma. Methods A total of 374 children with bronchial asthma who were treated in Jianyang People′s Hospital from December 2018 to December 2020 were enrolled.Pharyngeal swabs were collected from the outpatient children on the day of treatment, and 2 mL of nasopharyngeal secretions were collected from the hospitalized children within 24 hours by negative pressure aspirator.Seven viral antigens including RSV,ADV,IVA,IVB,PIVI,PIV II,and PIV III were detected.According to whether the virus test results were positive or not, they were divided into the experimental group(n=191) and the control group(n=183).Logistic regression analysis was used to screen the risk factors of respiratory virus infection in children with bronchial asthma. Results Among the 374 samples, the virus positive rate was 51.07%(191/374),and the top 3 virus species in the positive samples were RSV,ADV,and PIV III,accounting for 41.36%(79/191),30.36%(58/191),and 9.42%(18/191),respectively.In addition, IVA accounted for 5.24%(10/191),PIV II accounted for 5.24%(10/191),PIVI accounted for 3.66%(7/191),and IVB accounted for 1.57%(3/191).The positive rates of virus were 47.96%(94/196) and 54.49%(97/178) in male and female children, respectively, with no significant difference(χ^(2)=1.597,P>0.05).The positive rate of 1~3 years old children was significantly higher than that of >3 years old group(χ^(2)=6.412,P<0.05).There were significant differences in the frequency of asthma attack, intravenous glucocorticoid application and the onset season between the two groups(P<0.05).Further analysis showed that the frequency of asthma attack >3 times, intravenous glucocorticoid application and onset season were independent risk factors for respiratory virus infection in children with bronchial asthma(P

关 键 词：儿童支气管哮喘 呼吸道病毒感染 病例对照 

分 类 号：R181[医药卫生—流行病学]