婴幼儿呼吸道合胞病毒和人鼻病毒感染所致急性下呼吸道感染特征及预后分析

Clinical characteristics and prognosis of acute lower respiratory tract infections caused by respiratory syncytial virus and rhinovirus infections in infants

目的 探讨婴幼儿呼吸道合胞病毒(RSV)和人鼻病毒(HRV)引起的急性下呼吸道感染的临床特征及预后分析。方法 回顾性分析2012-01至2017-12武警特色医学中心收治急性下呼吸道感染的婴幼儿患者138例。根据病毒感染情况分为单纯RSV感染组、单纯HRV感染组、RSV和HRV合并感染组。比较三组急性下呼吸道感染的临床特征,并分析婴幼儿期呼吸道病毒感染与6~8岁时复发性喘息、哮喘发生的关系。结果 共纳入138例患儿,其中84例单纯RSV感染、20例单纯HRV感染和34例合并感染。单纯RSV感染的婴幼儿年龄最小[(5.64±2.16)个月],呼吸衰竭比例最高(25.00%),对吸氧的需求最高(25.00%),差异均有统计学意义(均P<0.05)。末次随访时单纯RSV感染组、单纯HRV感染组和合并感染组反复喘息发生率依次为39.29%、20.00%和35.29%,哮喘发生率依次为7.14%,10.00%,11.76%,差异均无统计学意义。婴幼儿单纯RSV组中,有哮喘家族史患儿6~8岁期间发生反复喘息的比例(87.50%)高于无家族史者(23.08%),差异有统计学意义(P<0.001)。结论 单纯RSV感染婴幼儿具有更高呼吸衰竭比例,存在有哮喘家族史的RSV感染患儿6~8岁时发生反复喘息的概率较高。

Objective To investigate the clinical characteristics of acute lower respiratory tract infections caused by respiratory syncytial virus(RSV) and/or human rhinovirus(HRV) in infants.Methods Clinical data of 138 infantile patients with acute lower respiratory tract infection, who were admitted to Characteristic Medical Center of Chinese People’s Armed Police Force from January 2012 to December 2017, were divided into three groups: simple RSV group(84 cases), simple HRV group(20 cases), and coinfection group of RSV and HRV(84 cases). Clinical characteristics of the three groups were compared, and associations between respiratory viral infections, recurrent wheeze and asthma at aged 6-8 were analyzed.Results The infants with simple RSV infection was the youngest [(5.64±2.16) months, the proportion of respiratory failure was the highest(25.00%), the demand for oxygen was the highest(25.00%),and the difference was statistically significant(P<0.05). At the last follow-up visit, the rates of recurrent wheezing in RSV infection group, HRV infection group and RSV and HRV coinfection group were 39.29%, 20.00% and 35.29% respectively, and the rates of asthma were 7.14%, 10.00% and 11.76% respectively, with no significant difference(P>0.05). In the simple RSV group, the proportion of recurrent wheezing during the age of 6~8 years with family history of asthma(87.50%) was higher than that those without family history(23.08%) and the difference was statistically significant(P<0.001).Conclusion Infants with simple RSV infection are characterized by a higher proportion of respiratory failure, and infants with a family history of asthma are more likely to suffer from recurrent wheeze at the age of 6-8 years.