婴幼儿喘息与呼吸道病毒感染及过敏的关系

Relationship between wheezing and respiratory virus infection and sensitization in infants

目的探讨婴幼儿喘息与呼吸道病毒感染及过敏的关系。方法选择反复喘息(哮喘和喘息性支气管炎)患儿152例、毛细支气管炎(毛支)患儿191例、肺炎患儿101例,取鼻咽分泌物进行7种常见呼吸道病毒检测,同时取血筛查过敏原。结果3组患儿病毒检测总阳性率为60.4%,各组患儿病毒检测阳性率差异有显著性(P<0.01),但均以呼吸道合胞病毒(RSV)为主,其他病毒阳性率很低。所有患儿食物过敏阳性率为25.5%,吸入过敏原阳性率仅5.6%。3组患儿的过敏原阳性率差异有显著性(P<0.05或0.01),反复喘息组显著高于毛支组和肺炎组(P均<0.05),而后两组间差异无显著性。结论RSV是诱发婴幼儿喘息和喘息反复发作的主要病原;过敏是婴幼儿反复喘息发生的重要危险因素,而呼吸道合胞病毒感染的发生与患儿是否存在过敏无关。

Objectives To investigate the relationship between wheezing and respiratory virus infection and sensitization in infants. Methods 152 infants with recurrent wheezing diagnosed as asthma or asthmatic bronchitis,191 infants with bronchiolitis,and 101 infants with pneumonia were enrolled in this study,nasopharyngeal secretions and peripheral blood were taken for detecting virus and allergens. Seven respiratory viruses were detected in nasopharyngeal secretions samples,and sensitinogen screening test with measuring the total IgE level were performed in blood samples. Results It was found that the total virus positive rate was 60.4 % with significant difference （P 〈 0.01 ） among these three groups. Respiratory syncytial virus （RSV） was the most common pathogen in seven respiratory viruses. The total food allergy and inhale sensitization rate was 25.5 % and 5.6 %,respectively with significant difference in these three groups （P 〈 0.05 and 0.01 ）. The food allergy and inhale sensitization rate of recurrent wheezing group were both higher than the other two groups （P 〈 0.05） ,but there was no different between bronchiolitis group and pneumonia group. Conclusions RSV is the main respiratory virus associated with wheezing and recurrent wheezing in infants. Sensitization may be an important risk factor of recurrent wheezing. Whereas the prevalence of respiratory virus infection seems no correlation to sensitization.