急性下呼吸道感染及哮喘发作住院患儿病原学检测分析

Pathogenologic Detection Analysis of Acute Lower Respiratory Infections and Asthma Exacerbations in Hospitalized Children

目的:分析小儿急性下呼吸道感染病原学特征并探讨其与哮喘发作的相关性。方法:选取我院儿科门诊收治的2 356例急性下呼吸道感染患儿作为研究对象,取鼻咽深部分泌物,利用直接免疫荧光法对分泌物进行检测。荧光免疫实验测定患儿血清特异性Ig E水平,以lg E≥0.35 IU/m L作为特异性诊断标准;流式细胞仪检测患儿血液嗜酸粒细胞(TEC)的数量。结果:(1)2 356例急性呼吸道感染患儿中,阳性病毒检出371例(15.75%)。不同性别间阳性病毒检出率比较差异无统计学意义(χ2=12.365,P>0.05);不同年龄段患儿阳性病毒检出率比较差异有统计学意义,1岁以内患儿病毒阳性检出率最高,随着患儿年龄增大,病毒阳性检出率越低。(2)2 356例患儿鼻咽深部分泌物共检出5种常见病毒,分别为呼吸道合胞病毒(RSV)、腺病毒(AV)、流感病毒(IFV)、副流感病毒3型(PIV3)以及鼻病毒(RV),其中RSV阳性检出率最高271例(73.05%),PIV3阳性检出率次之44例(11.86%)。(3)AV感染易导致患儿肺炎的发作,IFV感染易导致患儿支气管炎的发作,RSV感染易导致患儿产生毛细支气管炎,RV和IFV感染则容易引起患儿哮喘发作。结论:小儿急性下呼吸道感染与哮喘发作密切相关;RV和IFV具有特异敏感性,是引起患儿哮喘发作的主要病因。

Objective： To analyze the pathogenic features of acute lower respiratory tract infection and explore its correlation with asthma. Methods： A total of 2,356 cases of acute lower respiratory infection children from pediatric outpatient department of our hospital were selected as research subjects,taken deep nasopharyngeal secretions,directed immunofluorescence was used to detect secretions.Immunofluorescence was used to measure serum specific Ig E,lg E ≥ 0. 35 IU / m L was selected as criteria. The number of blood flow cytometer eosinophils（ TEC） in children was tested. Results：（ 1） There were 2,356 children with acute respiratory infections,positive virus detected in 371 cases（ 15.75%）. Positive virus detection rates were not significantly different between different sexes（ χ^2= 12.365,P〉0.05）. Positive virus detection rates of different ages were significantly different,the highest positive detection rate was in children less than 1 year old,lower positive detection rates were in increasing age children.（ 2） A total of 2,356 cases of children with deep nasopharyngeal secretions were detected five common virus,Respiratory syncytial virus（ RSV）,Adenovirus（ AV）,Influenza virus（ IFV）,Parainfluenza virus type 3（ PIV3） and Rhinovirus（ RV）. Positive rate of RSV was highest with 271 cases（ 73.05%）,PIV3 positive rate,followed by 44 cases（ 11.86%）.（ 3） AV infection easily led to seizures in children with pneumonia,IFV infection easily led to the onset of bronchitis in children,RSV infection easily led children to produce bronchitis,RV and IFV infection was likely to cause asthma attacks in children. Conclusion： Acute lower respiratory infections are closely related to asthma,RV and IFV are major causes of asthma attacks in children.