非药物干预措施对儿童呼吸道合胞病毒感染的影响

Effect of non-pharmacological interventions on respiratory syncytial virus infection in children

目的探究非药物干预对儿童呼吸道合胞病毒感染的临床特征的影响,为疫情放开后预防呼吸道合胞病毒感染提供依据。方法选取2018年至2021年期间我院住院患儿中确诊为RSV感染者960名,按时间分为无非药物干预期间(2018年至2019年)和非药物性干预(non-pharmaceutical interventions,NPIs)期间(2020年至2021年)两组,收集两组患儿的病例信息,分析两组临床特征情况。结果共有960例患儿,其中无NPIs期间400例,NPIs期间560例,<6月龄组儿童发病率最高(54.3%),重症率为4.2%,无死亡病例。无NPIs期间RSV感染全年散发,NPIs期间RSV感染率随NPIs执行程度变化而变化,无明显季节性变化。无NPIs期间患儿喘息的发生率较高(43.8%vs 37.1%)、患肺炎比例较高(73.0%vs 65.7%)、淋巴细胞百分比,血小板计数、血红蛋白及谷丙转氨酶、乳酸脱氢酶、谷草转移酶的异常频率所占比例较高,住院天数较长[(5.4±1.6)d vs(5.1±1.6)d],差异均有统计学意义(P<0.05)。无NPIs期间RSV感染患儿呼吸频率(respiratory rate,RR)较高,达峰时间比(time to peak tidal expiratory flow as a proportion of expiratory time,TPEF/TE)、达峰容积比(volume to peak expiratory flow as a proportion of exhaled volume,VPEF/VE)较低,差异均有统计学意义(P<0.05),重症发生率两个时期比较差异无统计学意义(P>0.05)。结论NPIs期间RSV感染流行季节被扰乱,且RSV患儿的气道损伤较轻,两个时期重症率无变化。

Objective To explore the effect of non-pharmacological interventions on the clinical characteristics of respiratory syncytial virus(RSV)infection in children,in order to provide evidence for the prevention of RSV infection after the pandemic control measures are lifted.Methods A total of 960 hospitalized children diagnosed with respiratory syncytial virus(RSV)infection in our hospital from 2018 and 2021 were selected.They were divided into two groups based on the time period:the group without non-pharmaceutical interventions(2018-2019)and the group with non-pharmacological interventions(NPIs)(2020-2021).The clinical information of both groups was collected and analyzed to compare their clinical characteristics.Results A total of 960 cases were included,with 400 cases during the period without NPIs and 560 cases during the NPIs period.The highest incidence was observed in children under 6 months of age,reaching 54.3%.The severe rate was 4.2%,and there was no reported death.During the period without non-pharmaceutical interventions(NPIs),RSV infections were distributed throughout the year.During the period with NPIs,the RSV infection rate varied with the degree of NPI implementation and showed no significant seasonal changes.The occurrence of wheezing(43.8%vs 37.1%),pneumonia(73.0%vs 65.7%),abnormal lymphocyte ratio,platelet count,hemoglobin levels,alanine aminotransferase,lactate dehydrogenase and alanine aminotransferase frequency were all higher during the period without NPIs.The hospitalized duration was also longer during this period[(5.4±1.6)days vs(5.1±1.6)days].These differences were all statistically significant(P<0.05).During the period without NPIs,RSV-infected children had higher respiratory rate(RR),lower time to peak tidal expiratory flow as a proportion of expiratory time(TPEF/TE),and lower volume to peak expiratory flow as a proportion of exhaled volume(VPEF/VE).These differences were all statistically significant(P<0.05).However,there was no statistically significant difference in the incidence of severe cases between the two periods(P>0.05).Conclusion During the period of NPIs,the seasonal patterns of RSV infection are disrupted,and the respiratory tract damage in children with RSV is milder.There is no change in the severity rate between the two periods.