不同年龄段儿童鼻病毒的检测及临床特点

Detection of rhinovirus in children of different ages and the clinical features

目的了解不同年龄段儿童鼻病毒的检测结果及临床表现。方法采集2019年1—12月汕头大学医学院第二附属医院住院的2908例呼吸道感染患儿的咽拭子,应用多重PCR和Luminex悬浮液态芯片技术进行呼吸道病原体核酸检测,对单一鼻病毒阳性的病例分年龄段进行分析,比较其检测结果、临床症状、影像学及实验室检查指标特点。结果单一鼻病毒阳性170例(5.85%,170/2908),不同年龄组间阳性率比较差异有统计学意义(χ2=9.66,P<0.05),以>28日龄~1岁组阳性率最高(7.80%),>1~3岁组阳性率最低(4.50%)。不同年龄组间均可出现发热、咳嗽、喘息表现,分别以>6岁、>28日龄~1岁和>1~3岁组比例最高(χ2=12.82、21.78、12.54,P均<0.05)。≤28日龄组气促、发绀比例最高(43.75%、37.50%),头痛以>6岁年龄组比例最高(50.00%)。影像学显示3岁以下年龄组主要表现为支气管肺炎。不同年龄组间淋巴细胞计数升高和降低比例差异有统计学意义(χ2=31.41,29.90,P均<0.05)。结论鼻病毒在婴儿期检出率最高。新生儿以气促、发绀为主要表现,胸片以支气管肺炎为主;婴幼儿以咳嗽、喘息为主要表现;学龄期儿童主要表现为发热、头痛,胸片结果多正常。

Objective To understand the detection results and clinical characteristics of rhinovirus infection in children of different ages.Methods Throat swabs were collected from 2908 children with respiratory tract infection hospitalized in the Second Affiliated Hospital of Shantou University Medical College from January to December 2019.Nucleic acid of respiratory pathogens was detected by multiplex PCR and Luminex suspension liquid Microarray.The cases with single rhinovirus infection were analyzed by different ages,and the detection results,clinical symptoms,imaging features and laboratory findings were compared.Results There were 170 cases with single rhinovirus infection(5.85%,170/2908).The positive rates in different age groups were significantly different(χ2=9.66,P<0.05)with the highest rate in>28 days-1 year old group(7.80%)and the lowest rate in>1-3 years old group(4.50%).Symptoms of fever,cough and wheezing could occur in different age groups with the highest proportions in>6,>28 days-1 year old and>1-3 years old groups,respectively(χ2=12.82,21.78 and 12.54,P all<0.05).The proportions of shortness of breath and cyanosis were the highest in the age group of≤28 days(43.75%and 37.50%),and the proportion of headache was the highest in>6 years old group(50.00%).The chest X-ray results showed that bronchopneumonia was common in children under 3 years old.The proportions of increased and decreased lymphocyte count were significantly different in different age groups(χ2=31.41 and 29.90,P both<0.05).Conclusions The detection rate of rhinovirus is the highest in infancy.The main symptoms of infected newborns are shortness of breath and cyanosis,and the chest X-ray usually shows bronchopneumonia.The main symptoms of infected infants are cough and wheezing.In school-aged children,the main symptoms are fever and headache,and the results of chest X-ray are usually normal.