146例新生儿呼吸道合胞病毒临床分析

Clinical analysis of 146 cases of neonatal respiratory syncytial virus

目的:探讨新生儿呼吸道合胞病毒(RSV)感染的特点,为新生儿RSV感染的防控提供数据参考。方法:选择2017年1月至2019年10月在梅州市妇幼保健计划生育服务中心新生儿科拟诊为下呼吸道感染633例患儿作为研究对象,观察患儿RSV发生率及发病特征。结果:633例下呼吸道感染患儿中RSV确诊146例,检出率为23.06%。随着患儿日龄增加,RSV感染患儿发病率显著增加,组间比较差异有统计学意义(P<0.05)。RSV感染冬春季高发,夏季和秋季发病很低,差异有统计学意义(P<0.05)。进一步分析显示,1月和2月发病率最高,其次是11月和12月。RSV和非RSV患儿年龄、性别、出生体质量、咳嗽、喘息、呼吸困难、紫绀、拒伤、喘鸣音、白细胞、C反应蛋白、肝酶异常、肌酸激酶异常等相比较差异无统计学意义(P>0.05),RSV感染患儿早产、呼吸急促、湿啰音、胸片异常、细菌感染发生率高于非RSV组患儿,发热率低于非RSV患儿,差异有统计学意义(P<0.05)。经对症处理和支持治疗,所有患儿均符合出院标准。结论:RSV感染是本地区住院新生儿下呼吸道感染的重要病因,多发于冬春季节,随着新生儿年龄增加,发病率呈升高趋势,对新生儿下呼吸道感染进行干预时,应根据患儿病情特征考虑RSV感染的可能并进行针对性干预,以改善患儿临床结局。

Objective:To explore the characteristics of neonatal respiratory syncytial virus(RSV)infection and provide data for the prevention and control of RSV infection.Methods:From January 2017 to October 2019,633 children with lower respiratory tract infection were selected as the study objects,and the incidence and characteristics of RSV were observed.Results:Among 633children with lower respiratory tract infection,146 cases were confirmed RSV,the detection rate was 23.06%.With the increase of age,the incidence of RSV infection increased significantly(P<0.05).RSV infection was higher in winter and spring,but lower in summer and autumn(P<0.05).Further analysis showed that the highest incidence was in January and February,followed by November and December.There were no significant difference in age,sex,birth weight,cough,wheezing,dyspnea,cyanosis,injury rejection,wheezing,leukocyte,C-reactive Protein,liver enzyme and creatine kinase between RSV and non RSV children(P>0.05).The incidence of Premature delivery,shortness of breath,moist rales,abnormal chest radiograph and bacterial infection in children with RSV infection was higher than that in children without RSV infection,and the fever rate was lower than that in children without RSV infection,with statistical significance(P<0.05).After symptomatic treatment and supportive treatment,all the children met the discharge standard.Conclusion:RSV infection is an important cause of lower respiratory tract infection in hospitalized neonates in this area,which mainly occurs in winter and spring.With the increase of the age of the newborn,the incidence is increasing.In order to improve the clinical outcome,we should consider the Possibility of RSV infection according to the characteristics of children’s condition.