2021 年第 9 期 第 16 卷

鼻病毒感染所致下呼吸道感染患儿临床特征分析

Clinical characteristics of children with lower respiratory tract infection caused by rhinovirus infection

作者：陈晶晶1崔玉霞2黄栋3

英文作者：Chen Jingjing1 Cui Yuxia2 Huang Dong3

单位：1贵州医科大学临床医学院,贵阳550002；2贵州省人民医院儿科,贵阳550002；3贵州省人民医院儿童重症医学科,贵阳550002

英文单位：1Clinical Medical College of Guizhou Medical University Guiyang 550002 China； 2Department of Pediatrics Guizhou Provincial People′s Hospital Guiyang 550002 China； 3Department of Pediatric Intensive Care Unit Guizhou Provincial People′s Hospital Guiyang 550002 China

关键词：下呼吸道感染；儿童；鼻病毒

英文关键词：Lowerrespiratorytractinfection;Children;Rhinovirus

• 摘要：

• 目的 探讨鼻病毒感染所致下呼吸道感染（LRTI）患儿的临床特征。方法 连续纳入贵州省人民医院2019年1—12月收治的LRTI患儿173例，患儿入院当日均接受鼻咽分泌物多重聚合酶链反应检测，分析鼻咽部标本中病原体检出情况和病原体类型，比较单一感染鼻病毒组（单一感染组）、鼻病毒合并1种病原体感染组（双重感染组）和鼻病毒合并2种及以上病原体感染组（多重感染组）基线资料、临床表现、基础疾病、并发症发生情况、机械通气比例和白细胞计数、C反应蛋白水平以及住院时间。结果 173例患儿中，8例（4.6%）鼻咽部标本中未检测出病原体，165例（95.4%）检测出至少1种病原体，其中检出 1种病原体96例（55.5%），检出2种病原体53例（30.6%），检出3种病原体10例（5.8%），检出4种病原体6例（3.5%）。共检出鼻病毒76株。76例鼻病毒感染患儿中单一感染组29例，双重感染组33例，多重感染组14例，双重感染组男性患儿比例和喘息比例均高于单一感染组［75.8%(25/33)比51.7%(15/29)，69.7%（23/33）比37.9%（11/29）］（均P＜0.05），单一感染组、双重感染组和多重感染组年龄和发热、咳嗽、呼吸困难临床表现，哮喘、室间隔缺损、房间隔缺损基础疾病情况，呼吸衰竭、心肌酶异常、肝功能异常、血小板升高、中性粒细胞减少等并发症发生情况，机械通气比例和白细胞计数、C反应蛋白水平以及住院时间比较差异均无统计学意义（均P＞0.05）。结论 鼻病毒是本地区引起LRTI最常见的病原体，且常与其他病原体混合感染。鼻病毒双重感染患儿以男性更多，更容易发生喘息症状。

• Objective To investigate the clinical characteristics of children with lower respiratory tract infection (LRTI) caused by rhinovirus infection. Methods From January to December 2019, 173 children with LRTI admitted to Guizhou Provincial People′s Hospital were continuously enrolled. The children received nasopharyngeal secretions multiple polymerase chain reaction detection on admission, and detection status and types of pathogens in nasopharyngeal specimens were analyzed. The baseline data, clinical manifestations, underlying diseases, incidence of complications, the proportion of mechanical ventilation, levels of white blood cell count and C-reactive protein, and length of stay were compared among the single rhinovirus infection group (single infection group), rhinovirus combined with one pathogen infection group (double infection group) and rhinovirus combined with two or more pathogens infection group (multiple infection group). Results Among 173 cases of children, 8 cases (4.6%) had no pathogen detected in nasopharyngeal secretions, and 165 cases (95.4%) had at least one pathogen detected, among which 96 cases (55.5%) had one pathogen, 53 cases (30.6%) had two pathogens, 10 cases (5.8%) had three pathogens and 6 cases (3.5%) had four pathogens. A total of 76 strains of rhinovirus were detected, including 29 cases of single infection group, 33 cases of double infection group and 14 cases of multiple infection group. The proportions of boy and wheezing in the double infection group were higher than those in the single infection group［75.8%(25/33) vs 51.7%(15/29)， 69.7%（23/33） vs 37.9%（11/29）］(both P<0.05). There were no significant differences in age, clinical manifestations of fever, cough and dyspnea, underlying diseases such as asthma, ventricular septal defect and atrial septal defect, complications such as respiratory failure, abnormal cardiac enzymes, abnormal liver function, elevated platelets and neutropenia, the proportion of mechanical ventilation, white blood cell count, C-reactive protein level, and length of stay among single infection group, double infection group and multiple infection group(all P>0.05). Conclusions Rhinovirus is the most common pathogen causing LRTI in this area, and is often complicated with other pathogens. Boys with rhinovirus double infection are more common and more likely to have wheezing symptoms.