探讨大样本呼吸道感染并血小板计数异常升高婴幼儿的病原学分析

Etiological analysis of large sample of children with respiratory tract infection complicated with platelet abnormalities

目的观察呼吸道感染并血小板计数异常升高婴幼儿的病毒病原学特征,为该病临床诊治提供参考。方法将本院918例呼吸道感染婴幼儿(2017年1月至2018年9月期间收治)按临床诊断血小板计数是否异常升高分为血小板升高组(简称:血高组,共386例)和血小板计数正常组(简称:血正组,共532例),采用RT-PCR检测法对鼻咽分泌物进行14种常规病毒病原检测。结果血高组和血正组婴幼儿均以HRV检出率最高(44.30%和42.48%),差异无显著性(P>0.05)。血高组PIV3检出率(29.27%)显著高于血正组(19.92%),而血高组IFVB检出率(4.15%)显著低于血正组(14.85%),差异具有显著性(P<0.05)。血高组共315例(81.61%)检测出病毒病原,血正组共430例(80.83%)检测出病毒病原,差异无显著性(P>0.05)。血高组和血正组婴幼儿的病毒病原检出率,在年龄分布上比较具有显著差异性(X^2=36.253,P<0.05),血高组月龄小于12月婴幼儿的检出占比高达51.43%。结论本地区呼吸道感染婴幼儿血小板计数异常升高较为常见,PIV3感染可能是本地区呼吸道感染婴幼儿血小板计数异常升高的重要原因,月龄小于12月的呼吸道感染更易出现血小板计数异常升高,必须给予PIV3感染及月龄小于12月婴幼儿临床关注。

Objective To observe the viral pathogenic characteristics of infants with respiratory tract infection and abnormal elevation of platelet count,so as to provide reference for clinical diagnosis and treatment of this disease.Methods 918 infants with respiratory tract infections from January 2017 to September 2018 were divided into the platelet elevation group(386 cases)and the normal platelet count group(532 cases)according to the clinical diagnosis of abnormal elevation of platelet count.14 kinds of common viral pathogens were detected by RT-PCR in nasopharyngeal secretions. Results HRV detection rate was the highest (44.30% and 42.48%) in both the high blood group and the positive blood group, with no significant difference ( P> 0.05). The detection rate of PIV3 in the high blood group (29.27%) was significantly higher than that in the positive blood group (19.92%), while the detection rate of IFVB in the high blood group (4.15%) was significantly lower than that in positive blood group (14.85%), with significant difference ( P< 0.05). Viral pathogens were detected in 315 cases (81.61%) of the high blood group and 430 cases (80.83%) of the positive blood group, with no significant difference ( P> 0.05). The detection rate of viral pathogens in the blood-high group and the blood-positive group was significantly different in age distribution (X 2=36.253, P< 0.05), especially in infants less than 12 months old. The detection rate of the blood-high group was 51.43% in December. Conclusion The abnormal increase of platelet count in infants with respiratory tract infection is common in this area. PIV3 infection may be an important reason for the abnormal increase of platelet count in infants with respiratory tract infection in this area. The abnormal increase of platelet count is more likely to occur in infants with respiratory tract infection less than 12 months old. Clinical attention must be paid to PIV3 infection and infants with monthly age less than 12 months old.