Objective To explore the clinical characteristics of human bocavirus (HBoV) infection in the children with severe lower respiratory tract infection.Methods The clinical data of the hospitalized children with sputum HBoV-positive were analyzed retrospectively,who were hospitalized at the Pediatric Intensive Care Unit of Children's Hospital Affiliated to Capital Institute of Pediatrics from September 1,2016 to March 31,2017.Results A total of 17 children were included in the study.The ratio of male to female was 15 ∶ 2.The diagnostic age ranged from 4 months to 4 years and 10 months old.82.4％ (14/17 cases) of the patients were infants less than 2 years old.Autumn and winter were high-occurrence seasons.Pediatric Critical Illness Scores(PCIS) were 68-88 scores(median 82 scores).PCIS was less than 70 scores in 1 case,and between 70 scores and 80 scores in 7 cases,and more than 80 scores in 9 cases.The main clinical manifestations were respiratory system involvement,including dyspnea in 17 cases (100％),fever in 14 cases (82.4％),cough in 16 cases (94.1％),wheezing in 13 cases (76.5％),and moist rales in 13 cases (76.5％).The main abnormal chest radiological findings showed patchy shadows in 7 cases (41.2％) and consolidation in 6 cases (35.3％).The oxygenation index was 73.9-296.0 mmHg(1 mmHg =0.133 kPa),and median was 176 mmHg.The oxygenation index was between 100-200 mmHg in 7 cases(41.2％),and less than 100 mmHg in 2 cases(11.7％).Type Ⅰ respiratory failure occurred in 11 cases (64.7％),while type Ⅱ respiratory failure occurred in 6 cases (35.3 ％).All of the patients need respiratory support with mechanical ventilation.Among them,6 patients (35.3％) were treated by non-invasive ventilation and their ventilation time were 25-128 h(median 65 h),while 11 patients (64.7％) were treated by invasive ventilation and their ventilation time was 42-178 h(median 70 h).Other organ or system dysfunction is mild.The length of hospital stay ranged from 3 days to 13 days.The cure rate was 100％.Conclusions HBoV infection in the children with severe lower respiratory tract infection is common in infants under 2 years old,with acute onset and rapid recovery.The obvious clinical symptoms are fever,cough,wheezing and dyspnea.Although respiratory failure is common,other organ or system dysfunction is mild,which may bring about a good prognosis.%目的 探索儿童重症人博卡病毒下呼吸道感染的临床特点.方法 回顾性分析首都儿科研究所附属儿童医院重症医学科2016年9月1日至2017年3月31日人博卡病毒检测阳性住院患儿的临床资料.结果 共17例患儿纳入分析,男女比例为15:2,年龄4个月～4岁10个月,＜2岁婴幼儿占82.4％(14/17例),秋冬季节多发.小儿危重评分68～88分,中位数82分,≤70分1例,70～ 80分7例,＞80分9例.临床以肺部受累为主,表现为呼吸困难17例(100％)、发热14例(82.4％)、咳喘13例(76.5％)、肺部喘鸣音及湿哕音13例(76.5％).胸部影像学可见斑片影7例(41.2％)、实变影6例(35.3％).Ⅰ型呼吸衰竭11例(64.7％),Ⅱ型呼吸衰竭6例(35.3％).氧合指数73.9 ～ 296.0 mmHg(1 mmHg =0.133 kPa),中位数176 mmHg,100～ 200 mmHg者7例(41.2％),＜100 mmHg者2例(11.7％);所有患儿均需呼吸机辅助通气,其中无创呼吸机通气6例(35.3％),通气时间25～ 128 h,中位数65 h;有创呼吸机通气11例(64.7％),通气时间42～ 178 h,中位数70 h.肺外脏器受累轻.住院天数3～13 d.治愈好转100％.结论 儿童重症人博卡病毒下呼吸道感染多见于2岁以下婴幼儿,起病急,进展快,临床症状以发热、咳喘、呼吸困难为突出表现,易导致呼吸衰竭,但肺外脏器受累轻,预后良好.
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