新生儿呼吸道合胞病毒性肺炎的研究

Study of respiratory syncytial virus pneumonia in neonate

目的探讨新生儿呼吸道合胞病毒性肺炎的临床特点。方法对158例肺炎新生儿的病原进行检测,以直接荧光法检测呼吸道病毒抗原并做鼻咽吸出物细胞培养。对诊断为呼吸道合胞病毒性肺炎新生儿的临床资料进行总结。结果158例新生儿肺炎中检出呼吸道合胞病毒共59例(37.34%),日龄<21 d组检出率为23.68%(9/38),≥21 d组检出率为41.67%(50/120),2组检出率比较有显著性差异(P<0.05)。呼吸道合胞病毒与细菌混合感染共13例(8.23%)。入院时发热6例(10.17%);咳嗽呈阵咳或连咳54例(91.53%),气促53例(89.83%);肺部湿音44例(74.58%),仅闻及干音9例(15.25%),哮鸣音6例(10.17%)。X线支气管肺炎改变52例(88.14%),节段性实变影7例(11.86%)。日龄<21 d组与≥21 d组呼吸道合胞病毒性肺炎的症状、体征发生率无显著性差异(P>0.05)。单纯呼吸道合胞病毒感染与混合感染者症状、体征发生率亦无显著性差异(P>0.05)。结论呼吸道合胞病毒是新生儿肺炎的重要病原之一。新生儿呼吸道合胞病毒性肺炎混合感染率较高,呼吸道合胞病毒性肺炎临床表现缺乏特异性。

Objective It is to discuss the clinical characteristic of respiratory syncytial virus （RSV） pneumonia in neonate. Methods The pathogen of 158 cases of neonate pneumonia was detected. The respirovirus antigen was detected with direct fluorescence method and the cell culture of nasopharynx secreta was done, The clinical data of neonate who was diagnosed RSV pneumonia was summarized, Results 59 cases of neonate pneumonia were detected RSV （37.34 % ）. The detect rates in days of age 〈 21 d group was 23,68 % （9/38） and that in days of age ≥21 d group was 41.67 % （50/120）. There was significant difference between the two groups （ P 〈 0.05）. RSV and bacteria mixed infection was 13 cases （8.23 % ）, Febrility on admission was six cases （10, 17%）, Cough showed as paroxysmal cough and continuous cough was 54 cases （91.53%）, anhelation was 53 cases （89.83%）. Bellows moist rales was 44 cases （74.58%）, dry rales was 9 cases （15.25 % ）, wheezing tale was 6 cases （10.17 % ）. Bronchopneumonia change in X ray was 52 cases （88.14 % ）, segmented consolidation shadow was 7 cases （ 11.86 % ）. There was no significant difference on symptom and objective sign incidence rates of RSV pneumonia between days of age 〈21 d group and ≥21 d group （P〉0.05）. There was no significant difference on symptom and objective sign incidence rates between simple RSV infection and mixed infection （P 〉 0.05）. Conclusion RSV is one of the important pathogen of neonate pneumonia. The mixed infection rate of neonate RSV pneumonia is higher and the clinical manifestation of RSV pneumonia is short of specificity.