婴幼儿喘息的病因回顾分析

摘要

目的 分析婴幼儿喘息的病因.方法 收集西安市儿童医院2016年1月1日至12月31日以气喘为主诉住院的3岁以内患儿共1140例,将所收集的患儿病例根据年龄分为五组:0~ <3个月,3~ <6个月,6个月~ <1岁,1~ <2岁,2~3岁,回顾性分析其喘息的病因.结果 ①3岁以内患儿喘息的病因主要以感染相关喘息最多见,占总喘息例数的84.8%,支气管哮喘占9.4%,支气管异物占3.9%,多见于1~3岁患儿,先天性喉软骨发育不良占0.9%,多见于0~3个月患儿,其余如气管支气管狭窄、膈膨升、食管裂孔疝、支气管肺发育不良、闭塞性细支气管炎、肺发育畸形、气管性支气管均较为少见;②病毒感染相关喘息患儿中,呼吸道合胞病毒是病毒感染相关喘息的主要病原(占85.3%),流感病毒占32.9%,腺病毒占19.9%,副流感病毒占15.5%,其中混合病毒感染占28.3%,喘息患儿中肺炎支原体感染占10.4%,感染率相对较高,其中以6个月至3岁患儿多见;③呼吸道合胞病毒、副流感病毒、流感病毒、腺病毒及肺炎支原体均以秋冬季节感染率较高,具有明显的季节流行趋势.结论 婴幼儿喘息是一组多病因疾病,临床上应注意鉴别诊断,早期正确的诊断及治疗可有效减少社会疾病负担.%Objective To analyze the causes of wheezing in infants.Methods Altogether 1 140 infants less than 3 years old suffering from wheezing and hospitalized in Xi'an Children's Hospital from January 1 to December 31,2016 were collected and divided into five groups based on patient's age,including 0— <3 months,3 — <6 months,6 months — <1 year,1 — <2 years,and 2 —3 years.Causes of wheezing were retrospectively analyzed.Results For infants within 3 years wheezing related with infection was most common,accounting for 84.8% of total wheezing cases,bronchial asthma account for 9.4% and bronchial foreign body accounted for 3.9%,which was more common in infants at 1—3 years,Wheezing caused by congenital laryngeal cartilage dysplasia accounted for 0.9%,which was more common in infants at 0—3 months.Others such as tracheobronchial stenosis,diaphragmatic eventration,hiatal hernia,bronchopulmonary dysplasia,bronchiolitis obliterans,pulmonary deformity,tracheal bronchus were very rare.In wheezing cases related to viral infection,respiratory syncytial virus(RSV)was main cause for viral infection related wheezing,accounting for 85.3%,followed by influenza accounting for 32.9%,adenovirus 19.9% and parainfluenza virus 15.5%. Among the cases,wheezing related to mixed virus infection occupied 28.3%.Among infants with wheezing,mycoplasma pneumoniae infection accounted for 10.4%,and the infection rate was relatively high which was most common in infants aged from 6 months to 3 years.Infection rates of respiratory syncytial virus,parainfluenza virus,influenza virus,adenovirus and mycoplasma pneumoniae were all higher in autumn and winter,which had an obvious seasonal trend.Conclusion Infant wheezing is a set of diseases with many causes.More attention should be paid to clinical differential diagnosis,and early correct diagnosis and treatment can effectively reduce social burden of disease.