225例支气管哮喘急性加重期患儿呼吸道病原体检测及临床特征分析
[Detection of respiratory pathogens and clinical features in 225 children with acute exacerbation of bronchial asthma].
作者信息
Xie Tian, Zhong Li-Li, Huang Han, Lin Xiao-Juan, Xiao Ni-Guang, Peng Li, Li Yu, Yang Zhuo-Jie, Liu Si-Lan, Chen Yong-Qi
机构信息
Children's Medical Center, Hunan Provincial People's Hospital, Changsha 410002, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2020 Nov;22(11):1198-1203. doi: 10.7499/j.issn.1008-8830.2006024.
OBJECTIVE
To investigate the respiratory pathogens and clinical features in children with acute exacerbation of bronchial asthma.
METHODS
Nasopharyngeal swabs were collected from 225 children with acute exacerbation of bronchial asthma, aged <14 years, who attended the outpatient service or were hospitalized from August 2017 to August 2019. Quantitative real-time PCR was used to detect 12 pathogens, i.e., respiratory syncytial virus (RSV), human rhinovirus (HRV), influenza virus A (IFVA), influenza virus B (IFVB), parainfluenza virus types 1-3 (PIV1-3), human metapneumovirus (HMPV), adenovirus (ADV), Bordetella pertussis (BP), Chlamydia pneumoniae (CP), and Mycoplasma pneumoniae (MP).
RESULTS
The overall detection rate of virus was 46.2% (104/225), and 7 kinds of viruses were detected, i.e., HRV (19.6%, 44/225), ADV (16.0%, 36/225), IFVB (5.8%, 13/225), RSV (4.9%, 11/225), IFVA (3.6%, 8/225), PIV3 (1.8%, 4/225), and HMPV (0.4%, 1/225). Of all pathogens, BP had the highest detection rate of 28.4% (64/225), and the detection rates of MP and CP were 16.4% (37/225) and 0.4% (1/225), respectively. The mild exacerbation group had a higher detection rate of BP than the severe exacerbation group (P<0.05), while the severe exacerbation group had significantly higher detection rates of RSV and MP than the mild exacerbation group (P<0.05). There were significant differences in the proportion of children with paroxysmal cough, spasmodic cough, fever, lung rales and abnormal lung imaging findings among the simple BP infection, simple virus infection and simple MP infection groups (P<0.05).
CONCLUSIONS
BP, HRV, and MP are common respiratory pathogens detected in children with acute exacerbation of bronchial asthma, and respiratory virus infection is an important pathogen of acute exacerbation of asthma in children. Acute exacerbation of asthma caused by different pathogens has different clinical features and severities.
目的
探讨支气管哮喘急性加重期患儿的呼吸道病原体及临床特征。
方法
收集2017年8月至2019年8月在门诊就诊或住院的225例年龄<14岁的支气管哮喘急性加重期患儿的鼻咽拭子。采用实时荧光定量PCR检测12种病原体，即呼吸道合胞病毒（RSV）、人鼻病毒（HRV）、甲型流感病毒（IFVA）、乙型流感病毒（IFVB）、1-3型副流感病毒（PIV1-3）、人偏肺病毒（HMPV）、腺病毒（ADV）、百日咳博德特氏菌（BP）、肺炎衣原体（CP）和肺炎支原体（MP）。
结果
病毒总检出率为46.2%（104/225），共检出7种病毒，即HRV（19.6%，44/225）、ADV（16.0%，36/225）、IFVB（5.8%，13/225）、RSV（4.9%，11/225）、IFVA（3.6%，8/225）、PIV3（1.8%，4/225）和HMPV（0.4%，1/225）。所有病原体中，BP检出率最高，为28.4%（64/225），MP和CP的检出率分别为16.4%（37/225）和0.4%（1/225）。轻度加重组BP检出率高于重度加重组（P<0.05），而重度加重组RSV和MP检出率明显高于轻度加重组（P<0.05）。单纯BP感染、单纯病毒感染和单纯MP感染组患儿阵发性咳嗽、痉挛性咳嗽、发热、肺部啰音及肺部影像学异常表现的比例差异有统计学意义（P<0.05）。
结论
BP、HRV和MP是支气管哮喘急性加重期患儿常见的呼吸道病原体，呼吸道病毒感染是儿童哮喘急性加重的重要病原体。不同病原体所致哮喘急性加重具有不同的临床特征和严重程度。
Zotero 插件