不同病毒所致毛细支气管炎患儿临床特征及血清和尿液白三烯水平的比较研究

Clinical characteristics and leukotriene levels in serum and urine of bronchiolitis children infected with different viruses

目的探讨呼吸道合胞病毒(respiratory syncytial virus,RSV)、人鼻病毒(human rhinovirus,HRV)、人偏肺病毒(human metapneumovirus,hMPV)感染的毛细支气管炎患儿临床特征及白三烯(leukotrienes,LTs)水平差异,为LTs受体拮抗剂(leukotriene receptor antagonist,LTRA)治疗毛细支气管炎提供临床依据。方法以2017年1月至2018年12月住院的90例毛细支气管炎患儿为研究对象,检测患儿呼吸道标本的病毒核酸,根据结果分成RSV组、HRV组、hMPV组3个实验组,对比临床资料并检测血、尿的LTs水平,以30例健康儿童的LTs水平为对照组。结果3个实验组在年龄、性别、体重、家族过敏史、既往过敏史等一般情况上均无明显差异。实验组的LTs水平均高于对照组,差异有统计学意义(P<0.05)。各实验组血和尿LTs水平存在正相关(r=0.723,P=0.016)。RSV组LTs水平最高、肺功能最差、临床评分最高,与HRV组、hMPV组差异有统计学意义(均P<0.01),但HRV组与hMPV组间LTs水平差异无统计学意义(P>0.05)。RSV组与hMPV组发热天数差异无统计学意义,但均大于HRV组(均P<0.01)。3个实验组间咳嗽、喘息天数差异无统计学意义(均P>0.05)。结论RSV感染毛细支气管炎患儿LTs水平最高、肺功能最差、临床评分最高,与HRV组、hMPV组的差异有统计学意义。

Objective To investigate the differences of clinical characteristics and leukotrienes(LTs)level of bronchiolitis children infected with respiratory syncytial virus(RSV),human rhinovirus(HRV)and human metapneumovirus(hMPV),and provide clinical evidence for the treatment of bronchiolitis with LTs receptor antagonist(LTRA)montelukast.Methods Totally 90 children with bronchiolitis hospitalized from January 2017 to December 2018 were enrolled into this study and viral nucleic acid from respiratory tract specimens were detected;and the patients were divided into three experimental groups:RSV group,HRV group and hMPV group.The clinical data and LTs level in blood and urine of experimental groups were compared;30 healthy children were enrolled as the control group.Results There were no significant differences in age,sex,weight,family history and past history of allergy among the three experimental groups.The LTs levels in the experimental groups were higher than that of control group(P<0.05).There was a positive correlation between the LTs levels in blood and urine(r=0.723,P<0.05).In RSV group,LTs level of was the highest,lung function was the worst,and clinical score was the highest,and significantly different from those of HRV group and hMPV group(all P<0.01).However,there was no significant difference between HRV group and hMPV group.The number of days with fever of RSV group and hMPV group were not significantly different,but both were higher than that of HRV group(all P<0.01).The number of days with cough and wheezing among experimental groups had no significant difference(all P>0.05).Conclusions The bronchiolitis children infected with RSV had the highest LTs level,the worst lung function and the highest clinical score,there was significant difference when compared with HRV group and hMPV group.