急性呼吸道腺病毒感染患儿混合感染临床特征分析

Clinical Characteristics of Mixed Infection in Children with Acute Respiratory Adenovirus Infection

目的:探究急性呼吸道腺病毒(acute respiratory adenovirus,ADV)感染患儿混合感染的临床特征。方法:回顾性分析2019年1-9月于泉州市妇幼保健院·儿童医院接受治疗的63例ADV感染患儿的临床资料,采集其鼻咽部分泌物,使用实时荧光聚合酶链式反应(polymerase chain reaction,PCR)技术测定腺病毒、鼻病毒等30种呼吸道病原体,根据其病原体检出情况分为混合感染组及单一感染组。比较两组临床症状、流行病学、住院时间及转归情况。结果:经统计,63例ADV感染患儿中单一感染阳性率为19.05%(12/63),而混合感染阳性率为80.95%(51/63)。两组临床症状(咳嗽、发热、咳痰)比较,差异无统计学意义(P>0.05)。两组性别、好发年龄段、临床诊断比较,差异均无统计学意义(P>0.05),而发病季节分布情况比较,差异有统计学意义(P<0.05),混合感染组发病主要集中于4~9月(84.31%),单一感染组发病主要集中于4~6月(91.67%)。两组均痊愈出院,混合感染组住院时间长于单一感染组(P<0.05)。结论:ADV患儿混合感染的主要表现为咳嗽、发热及咳痰,男女比例为1.32∶1,好发年龄段为0~4岁,主要以腺病毒混合肺炎链球菌及肺炎支原体为主。

Objective:To explore the clinical characteristics of mixed infection in children with acute respiratory adenovirus(ADV)infection.Method:A total of 63 children with ADV infection who were treated in Quanzhou Maternity and Child Hospital·Children’s Hospital from January to September 2019 were retrospectively analyzed.Their nasopharyngeal secretions were collected,and 30 respiratory pathogens such as adenovirus and rhinovirus were detected by real-time polymerase chain reaction(PCR),which were divided into mixed infection group and single infection group according to the detection of pathogens.The clinical symptoms,epidemiology,hospital stay and outcome of the two groups were compared.Result:According to the statistics,the positive rate of single infection was 19.05%(12/63),while the positive rate of mixed infection was 80.95%(51/63)in 63 children with ADV infection.There were no significant differences in clinical symptoms(cough,fever,expectoration)between the two groups(P>0.05).There were no significant differences in gender proportion,age of predilection and clinical diagnosis between the two groups(P>0.05),but there was significant difference in the distribution of disease season(P<0.05).The incidence of mixed infection group was mainly from April to September(84.31%),and that of single infection group was mainly from April to June(91.67%).Both groups were cured and discharged,and the hospitalization time of mixed infection group was longer than that of single infection group(P<0.05).Conclusion:The main manifestations of ADV mixed infection in children are cough,fever and expectoration,the ratio of male to female is 1.32∶1,and the most common age group is 0~4 years old,mainly adenovirus mixed Streptococcus pneumoniae and Mycoplasma pneumoniae.