首页|<5岁门诊儿童严重急性呼吸道感染的病毒病因学研究及其与预后的关系

<5岁门诊儿童严重急性呼吸道感染的病毒病因学研究及其与预后的关系

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目的 探讨<5岁门诊儿童严重急性呼吸道感染(SARI)的病毒病因学研究及其与预后的关系。方法 纳入2022年1月至2023年12月西安市儿童医院门诊接收的199例SARI患儿的资料。在纳入研究48 h内,采集鼻咽拭子,并通过聚合酶链式反应(PCR)确定小儿SARI病毒病因。多元线性回归分析SARI患儿呼吸支持和住院时间的影响因素。结果 在纳入的199例患儿中,183例鼻咽拭子阳性,阳性率为92。0%。在124例(62。3%)阳性患儿中发现了 1种病原体,53例(26。6%)阳性患儿中发现了 2种病原体,6例(3。0%)阳性患儿中发现了 3种病原体。最常检测到的病毒是:鼻病毒(42。7%,85/199)、呼吸道合胞病毒(33。2%,66/199)、副流感病毒(14。1%,28/199)。从0~6个月的婴儿中收集的样本中有40份(54。8%)检测到呼吸道合胞病毒,显著高于其他年龄组中发现的频率(P<0。05)。腺病毒在>12~24个月年龄组中更常见(22。O%)。年龄别体重Z评分(β=-0。223,95%CI=-1。042~-0。136,P=0。011)、SpO2(β=-0。237,95%CI=-0。218~-0。037,P=0。006)是SARI患儿呼吸支持天数的影响因素。年龄别体重Z评分(β=-0。223,95%CI=-1。049~-0。124,P=0。013)、SpO2(β=-0。209,95%CI=-0。204~-0。020,P=0。017)是 SARI患儿住院时间的影响因素。结论 本研究的发现强调了病毒作为SARI相关病原体在该人群中的重要性。可以通过测量年龄别体重Z评分、入院时SpO2来识别处于严重病程风险中的儿童。
Viral etiology and prognosis of severe acute respiratory tract infection in out-patient children under 5 years of age
Objective To investigate the etiology and prognosis of severe acute respiratory infection(SARI)in<5 year old outpatients.Methods The data of 199 children with SARI admitted to the outpatient department of the Xi'an Children's Hospital from January 2022 to December 2023 were included.Nasopharyngeal swabs were collected and the etiology of SARI virus in children was determined by polymerase chain reaction(PCR)within 48 h of study inclusion.The factors influencing respiratory support and length of stay in SARI children were analyzed by multiple linear regression.Results Among the 199 patients included,183 patients had positive nasopharyngeal swabs,with a positive rate of 92.0%.One pathogen was found in 124(62.3%)positive patients,two pathogens were found in 53(26.6%)positive patients,and three pathogens were found in 6(3.0%)positive patients.The most commonly detected viruses were rhinovirus(42.7%,85/199),respiratory syncytial virus(33.2%,66/199)and parainfluenza virus(14.1%,28/199).Respiratory syncytial virus was detected in 40(54.8%)of the samples collected from infants aged 0 to 6 months,significantly higher than the frequency found in other age groups(P<0.05).Adenoviruses were more common in the>12-24 month age group(22.0%).Age-specific weight Z score(β=-0.223,95%CI=-1.042--0.136,P=0.011)and SpO2(β=-0.237,95%CI=-0.21--0.037,P=0.006)were the influencing factors for respiratory support days in children with SARI.Age-specific weight Z score(β=-0.223,95%CI=-1.049--0.124,P=0.013)and SpO2(β=-0.209,95%CI=-0.204--0.020,P=0.017)were the factors influencing the length of hospital stay in SARI children.Conclusions The findings of this study highlight the importance of viruses as SARI-associated pathogens in this population.Children at risk of a severe course of disease can be identified by measuring their age-specific weight Z score and SpO2 on admission.

Respiratory tract infectionsChildViral etiology

王雪、文俊、苏宇飞、章玉丹

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西安市儿童医院急诊科,西安 710016

呼吸道感染 儿童 病毒病因学

2024

中国医师杂志
中华医学会 湖南省医学会

中国医师杂志

CSTPCD
影响因子:0.876
ISSN:1008-1372
年,卷(期):2024.26(12)