贵阳市毛细支气管炎患儿痰中呼吸道七种病毒检测

An Analysis on Respiratory Seven Virus Detection Results in Sputum in 1050 Children with Capillary Bronchitis

目的:了解贵阳市毛细支气管炎患儿的病原谱和临床特征,为规范治疗毛细支气管炎提供依据。方法:选择住院治疗的毛细支气管炎患儿1 050例,经鼻取鼻咽部痰液做免疫荧光检测筛查7种常见呼吸道病毒抗原,同时做痰培养,并结合临床表型对检测标本阳性的病例进行统计分析。结果:1 050份标本中,病毒抗原阳性标本725份(69.0%);单一病毒抗原阳性以呼吸道合胞病毒(RSV)和副流感病毒(PIV)Ⅲ多见,分别占总阳性标本的30.5%(221/725)和8.7%(63/725),其次为腺病毒(Adv),占总阳性标本的7.3%(53/725);混合感染阳性标本占总阳性标本的55.3%(401/725),其中以RSV+痰培养阳性和Adv+痰培养阳性标本最多,分别占总阳性标本例数的44.9%(326/725)和4.4%(32/725);Adv感染、Adv合并RSV感染在喘息、发热、肺部体征吸收时间及住院天数方面较单纯RSV感染长,差异有统计学意义(P<0.05)。结论:毛细支气管炎病原体仍以RSV多见,PIVⅢ及Adv次之,部分合并细菌感染;Adv合并RSV感染时临床症状重,疗程长,故治疗上仍应以抗病毒、解痉止喘为主,只有在合并细菌感染时,方可加用抗生素治疗。

Objective： To understand pathogens and clinical features of children with capillary bron- chitis in the Guiyang area, so as to provide basis for start Methods： One thousand and fifty children with capillary dardizing the treatment of capillary bronchitis. bronchitis were selected. The sputum in naso- pharynx, via nasal was collected and tested for screening seven common respiratory viral antigens using immunofluorescence assay. Sputum culture was also processes. Combining with the clinical phenotype, the pathogen positive cases were statistically analyzed. Results： In 1 050 specimens, the virus antigen- positive specimens were 725 （69%）. A single viral antigen of RSV and PIV III was more, in which RSV positive samples were 221 （30.5% of the total positive specimens）, while PIV III was 63 （8.7%）. Then, Adv positive samples were 53 （7.3%）. Mixed infection-positive samples were 49. 4% （358/725）, in which RSV ＋ sputum culture positive specimens and Adv ＋ sputum culture positive samples were the most, 44. 9% （326/725） and 4. 4% （32/725） respectively. When chil- dren were infected by adenovirus and adenovirus combining with RSV, the course of wheeze and fever, duration of pulmonary symptoms and hospital stay were longer than those in the children infected by single RSV virus （ P 〈 0. 05 ）, with statistical significance. Conclusions： RSV pathogen in bronchioli- tis is still common, followed by PIV III and Adv. In some children with bacterial infection and adeno- virus combined with RSV infection, thier clinical symptoms are severe and treatment course is longer. Thus, the antiviral, anti-spasmolytic and anti-asthmatic treatments should be kept, only cases compli- cated with bacterial infection can be treated with antibiotics plus .