Objective To study the epidemiological and clinical characteristics of critical human bocavirus ( HBoV) pneumonia in chil dren. Methods From Jan. 2009 to Dec. 2010, the epidemiological and clinical characteristics of 27 cases of critical HBoV pneumonia and 106 cases of critical RSV pneumonia in Pediatric Intensive Care Unit, Children's Hospital Affiliated to Soochow University, were analyzed. Results The average age of 27 critical HBoV pneumonia cases was (1. 26 ±0.58) years old,which was significantly higher than that of critical RSV pneumonia group[ (0.49 ±0.57) years old] (P <0.05) ;66. 7% (18/27) cases of critical HBoV pneumonia occurred in autumn or winter, which had no significant difference to critical RSV pneumonia group (88.7% ). Fever was found in 66.7% ( 18/27) cases in critical HBoV pneumonia group,which was significantly higher than that in RSV pneumonia group (36. 8% ) ; proportion of wheezing in critical HBoV pneumonia group (40.7% ) was significantly lower than that in RSV pneumonia group (92. 5% ). In RSV pneumonia group,coughs in 100% (27/27) cases,diarrhea in 11.1% (3/27) cases,but no cases had convulsion or gastrointestinal bleeding. Proportion of abnormal oxy-genation index in all the cases was 66. 7% , and 14. 8% (4/27) cases received mechanical ventilation, and the mean ventilated time was (3.93 ± 1. 56) d, and no acute respiratory distress syndrome (ARDS) cases or dead cases were found. Creatine kinase - MB (CK - MB) in creased in 48.1%(13/27) cases,cardiac troponin I (cTnl) increased in 7.4% (2/27) cases,aspartate aminotransferase( AST) and alanine aminotransferase (ALT) increased in 14.8%(4/27) cases, and C reactive protein(CRP) increased in 44.4% (12/27) cases. Image change in both lungs was detected in 77. 8% (21/72) cases,lung marking around the hilus increased in 63.0% (17/27) cases,pulmonary emphysema in 88.9% (24/27) cases,small spot shadow in 55. 6% (15/27) cases,big range lesions in 14.8% (4/27) cases,pulmonary atelectasis in 14. 8% (15/27) cases,but pleural effusion and pneumothorax was not found in the patients. Conclusions Children with critical HBoV pneumonia are commonly younger than 2 years old,with a high occurrence in autumn and winter. They were present as fever,cough,wheezing and dyspnea, hypoxemia in varying degrees was always found, but ARDS did not occur. Pulmonary emphysema and lung marking change around the hilus were the major manifestations, and less pleural effusion and pneumothorax were found in imageology. For prophylaxis and therapy, they should be differentiated according to epidemiological and clinical features.%目的 了解人类博卡病毒(HBoV)感染所致儿童重症肺炎的流行病学及临床特点.方法 对2009年1月- 2010年12月本院PICU 27例重症HBoV肺炎患儿和106例重症RSV肺炎患儿的流行病学和临床特点进行比较分析.结果 重症HBoV肺炎患儿年龄(1.26±0.58)岁,显著大于重症RSV肺炎患儿[(0.49±0.57)岁](P＜0.05).重症HBoV肺炎患儿秋冬季发病占全年的66.7％(18/27例),与重症RSV肺炎患儿的88.7％(94/106例)比较差异无统计学意义；重症HBoV组66.7％(18/27例)的患儿有发热,高于重症RSV肺炎患儿的36.8％(39/106例)；40.7％ (11/27)重症HBoV肺炎患儿有喘息,低于重症RSV肺炎患儿的92.5％(98/106例).100％(27/27例)重症HBoV肺炎患儿伴有咳嗽,11.1％(3/27例)伴有腹泻,无抽搐和胃肠道出血发生,66.7％(18/27例)患儿入院时氧合指数低于300 mmHg(1 mmHg =0.133 kPa),14.8％(4/27例)予机械通气,通气时间为(3.93±1.56)d,但无急性呼吸窘迫综合征(ARDS)发生,无死亡病例；48.1％(13/27例)患儿CK-MB升高,7.4％(2/27例)患儿肌钙蛋白(cTnI)升高,14.8％(4/27例)患儿AST、ALT升高,44.4％(12/27例)患儿CRP升高；影像学检查77.8％(21/27例)患儿双肺受累,63.0％( 17/27例)表现为肺门周围纹理粗重,88.9％(24/27例)表现为肺气肿,55.6％(15/27例)有小斑片影,14.8％(4/27例)有大范围病灶,14.8％(4/27例)出现肺不张,未出现胸腔积液和肺气漏征象.结论 苏州地区重症HBoV肺炎多见于2岁以下患儿,秋冬季为发病高峰,以发热、咳嗽、喘息和呼吸困难为主要表现,可出现低氧血症,但无ARDS发生,影像学表现以肺气肿和两肺门周围纹理改变为主,较少出现胸腔积液和肺气漏征象.
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