兒童呼吸道腺病毒感染221例臨床分析

Clinical analysis of adenovirus respiratory infection in 221 children

目的分析兒童呼吸道腺病毒感染病例的臨床資料,探討其流行規律及疾病特征。方法回顧分析2014年1月~12月221例在本院住院,經鼻咽拭子呼吸道病毒基因檢測確診的兒童腺病毒呼吸道感染病例的臨床表現、實驗室檢查、影像學檢查、住院時間及治療經過。結果221例呼吸道腺病毒感染患兒,性別無明顯差異,發病高峰在7~9月及11~12月,所有病例均有發熱,以高熱為主,平均熱程6日,伴有咽痛、鼻塞、扁桃體腫大伴白色分泌物、結膜炎,實驗室檢查示白細胞總數升高,以中性粒細胞升高為主,高敏C反應蛋白明顯升高、降鈣素原升高。結論兒童腺病毒感染特點系高熱、熱程長、扁桃體炎伴分泌物,炎性指標上升,易與細菌感染尤其化膿性扁桃體炎混淆,血常規及常用炎性指標不能很好地鑒別腺病毒感染及化膿性扁桃體炎,應早期進行病毒測試明確診斷,避免抗生素濫用。

Objective To investigate the clinical and epidemic characteristics of adenovirus respiratory infection in children.Methods 221 hospitalized children with adenovirus respiratory infection were confirmed by nasal swab Luminex xTAG Respiratory Virus Panel(RVP Fast v2)from January to December 2014.Their clinical feature,lab result,chest x-ray,treatment and duration of hospitalization were analyzed retrospectively.Results In those 221 cases,there were no difference in sex ratio and the epidemic peaks were during July to September and November to December.The duration of fever was about six days.High fever,sore throat,stuffy nose,enlarged tonsil with white exudate,conjunctivitis,elevated WBC,neutrophil dominant,high CRP and PCT were noted in most of the cases.Conclusion High fever,long duration of fever,tonsillitis with white exudates,elevated inflammatory markers were the characteristics of adenovirus respiratory infection in children.The differential diagnosis between adenovirus and bacterial infection was difficult even though CBC and inflammatory markers were used.Rapid viral test should be done as soon as possible to confirm the diagnosis and avoid the misuse of antibiotics.