急性下呼吸道感染患儿病原学分析及其与哮喘发作的关系

摘要

Objective To investigate the prevalence of year-round respiratory viral infection in children with lower respiratory tract infection (LRTI), and the relationship between respiratory viral infection and allergen sensitization in exacerbating asthma. Methods A total of 231 hospitalized children with acute LRTI were investigated from May 2013 to April 2014. The 5 most common respiratory viruses were isolated from nasopharyngeal aspirate using multiplex reverse transcription-polymerase chain reaction, including respiratory syncytial virus (RSV), adenovirus (AV), parainfluenza virus (PIV), influenza virus (IFV) and rhinovirus (RV). Atopic sensitization was defined if more than 1 serum specific immunoglobulin E level measured using immunofluorescence experiment was over 0.35 IU/mL. Results RSV was the most common pathogen of bronchiolitis in hospitalized children through the year. RV or IFV infections were more prevalent in asthma exacerbations compared to other LRTIs. AV was more likely to cause pneumonia. RV and IFV were associated with asthma exacerbations in children with atopic sensitization, but not in nonatopic children. Conclusion RV and IFV are associated with hospitalization for asthma exacerbation in children with atopic sensitization.%目的 研究下呼吸道感染(LRTI)患儿全年的呼吸道病毒感染情况以及呼吸道病毒感染导致哮喘发作的关系.方法 选择2013年5月—2014年4月来我院的急性LRTI患儿231例为研究对象.从鼻咽抽出液中分离呼吸道合胞病毒(RSV)、腺病毒(AV)、副流感病毒(PIV)、流感病毒(IFV)和鼻病毒(RV)进行多重PCR扩增.应用荧光免疫实验测定血清特异性IgE水平,如果数值超过0.35 IU/mL则可认定为特异敏感性.结果 RSV是引起住院患儿毛细支气管炎的最常见病原,AV易导致肺炎.哮喘发作更易由RV和IFV感染引起,而IFV则是支气管炎的主要病原.结论 RV和IFV与具有特应敏感性住院患儿的哮喘急性发作有关.