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目的了解北京地区冬春季儿童、婴幼儿哮喘急性发作时的呼吸道常见病毒———呼吸道合胞病毒(RSV)、流感病毒(IFA1、IFA3、IFB)、副流感病毒(PIF1、PIF3)、腺病毒(ADV)的感染情况及与临床症状和嗜酸细胞的关系。方法对2000年11月至2001年3月及2001年11月至2002年3月,来首都儿科研究所哮喘中心就诊的哮喘急性发作的患儿176名,采用病毒分离及间接免疫荧光法,对鼻咽分泌物(nasopharyngealsecretions,NPS)中七种病毒抗原进行监测,并同时记录临床症状和用药情况及进行鼻咽分泌物和外周血中嗜酸细胞计数。结果176例哮喘急性发作患儿NPS中,79例检测出病毒,阳性率为44.9%。其中RSV66例,感染率为37.5%、IF7例(4.0%)、ADV6例(3.4%)及PIF4例(2.3%)。RSV占79例病毒感染患儿的83.5%;4例患儿同时测定出RSV和其他病毒混合感染。这些病毒在哮喘急性发作的患儿中检出率与年龄呈反比,小年龄组的患儿病毒感染多;检出病毒的患儿病情重,伴发热的患儿显著多于未检查出病毒的患儿。病毒感染与非感染组的NPS中嗜酸细胞数目检测无明显差别;但血中嗜酸细胞的数目,病毒检出阳性的患儿,较病毒测定阴性的患儿明显减少(t=2.676,P<0.001)。结论北京地区冬季近半数哮喘急性发作的患儿呼吸道病毒检测阳性,其中RSV是婴幼儿哮喘发作的主要感染病毒,引起较严重的临床症状;病毒检出阳性的患儿,血中嗜酸细胞的数目明显减少。
Objective To understand the prevalence of respiratory syncytial virus (RSV), influenza virus (IFA1, IFA3, IFB), parainfluenza virus (PIF1, PIF3), respiratory viruses in infants and young children in winter and spring in Beijing, (ADV) infection and its relationship with clinical symptoms and eosinophils. Methods From November 2000 to March 2001 and November 2001 to March 2002, 176 children with acute exacerbation of asthma who came to the Asthma Center of Capital Institute of Pediatrics were investigated by virus isolation and indirect immunofluorescence method. The seven virus antigens in nasopharyngeal secretions (NPS) were monitored. Clinical symptoms and medication were also recorded. Eosinophil counts in nasopharyngeal secretions and peripheral blood were also recorded. Results Of the 176 children with acute asthma attack, 79 were detected in the NPS, the positive rate was 44.9%. There were 66 cases of RSV, the infection rate was 37.5%, IF7 cases (4.0%), ADV6 cases (3.4%) and PIF4 cases (2.3%). RSV accounted for 83.5% of the 79 cases of viral infection in children; 4 cases of children with simultaneous determination of RSV and other virus mixed infection. The detection rate of these viruses in children with acute asthma attack is inversely proportional to the age, and there is more virus infection in children of the younger age group. Children with virus detected were significantly heavier and had more fever than those without virus detection Children. There was no significant difference in the number of eosinophils in NPS among the virus-infected and non-infected groups, but the numbers of eosinophils in blood and the virus-positive children were significantly lower than those in the negative children (t = 2.676, P <0.001). Conclusions In winter, almost half of the asthmatic children with asthma in Beijing were positive for respiratory virus infection. Among them, RSV was the main infectious virus in infants and young children with asthma attack, causing more serious clinical symptoms. In children with positive virus infection, blood eosinophil The number is significantly reduced.