中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2014年
6期
436-439
,共4页
鲁靖%殷菊%李云娟%王雷
魯靖%慇菊%李雲娟%王雷
로정%은국%리운연%왕뢰
呼吸道合胞病毒%下呼吸道感染%随访%特应性家族史%反复咳喘%婴儿,新生
呼吸道閤胞病毒%下呼吸道感染%隨訪%特應性傢族史%反複咳喘%嬰兒,新生
호흡도합포병독%하호흡도감염%수방%특응성가족사%반복해천%영인,신생
Respiratory syncytial virus%Lower respiratory tract infection%Follow-up%Family history of atopy%Recurrent cough or wheeze%Infant,newborn
目的 探讨新生儿呼吸道合胞病毒(RSV)下呼吸道感染的临床特点,及其与患儿出院后反复咳喘的关系.方法 选取2008年5月至2013年5月于北京新世纪儿童医院诊断为RSV下呼吸道感染的新生儿,对患儿临床资料及出院后随访结果进行分析.结果 共纳入41例RSV下呼吸道感染新生儿.41例均有咳嗽症状,38例(92.7％)有呛奶,13例(31.7％)有发热,27例(65.9％)患儿肺部有喘鸣音;12例(29.3％)合并细菌感染,最常见为金黄色葡萄球菌(50.0％,6/12例).RSV并细菌感染组患儿(12例)发热比例高于单纯RSV感染组(29例),差异有统计学意义(x2 =6.034,P＜0.05),而白细胞总数及胸片有片影2组间差异无统计学意义(x2=0.859、2.064,P=0.485、0.202).有特应性家族史的患儿与无特应性家族史的患儿比较,RSV下呼吸道感染时更易出现喘息(88.2％比57.1％,x2 =4.871,P＜0.05).出院后随访,患儿出现反复咳嗽和/或喘息组与无反复咳嗽和/或喘息组比较,前者有特应性家族史者比例更高(71.4％比26.3％,x2=6.388,P＜0.05).结论 新生儿RSV下呼吸道感染多表现为咳嗽、呛奶、部分患儿肺部查体可无喘鸣音,仅有湿啰音.新生儿RSV下呼吸道感染易合并细菌感染.有特应性家族史患儿RSV下呼吸道感染时更易出现喘息,RSV感染后更易出现反复咳喘.
目的 探討新生兒呼吸道閤胞病毒(RSV)下呼吸道感染的臨床特點,及其與患兒齣院後反複咳喘的關繫.方法 選取2008年5月至2013年5月于北京新世紀兒童醫院診斷為RSV下呼吸道感染的新生兒,對患兒臨床資料及齣院後隨訪結果進行分析.結果 共納入41例RSV下呼吸道感染新生兒.41例均有咳嗽癥狀,38例(92.7％)有嗆奶,13例(31.7％)有髮熱,27例(65.9％)患兒肺部有喘鳴音;12例(29.3％)閤併細菌感染,最常見為金黃色葡萄毬菌(50.0％,6/12例).RSV併細菌感染組患兒(12例)髮熱比例高于單純RSV感染組(29例),差異有統計學意義(x2 =6.034,P＜0.05),而白細胞總數及胸片有片影2組間差異無統計學意義(x2=0.859、2.064,P=0.485、0.202).有特應性傢族史的患兒與無特應性傢族史的患兒比較,RSV下呼吸道感染時更易齣現喘息(88.2％比57.1％,x2 =4.871,P＜0.05).齣院後隨訪,患兒齣現反複咳嗽和/或喘息組與無反複咳嗽和/或喘息組比較,前者有特應性傢族史者比例更高(71.4％比26.3％,x2=6.388,P＜0.05).結論 新生兒RSV下呼吸道感染多錶現為咳嗽、嗆奶、部分患兒肺部查體可無喘鳴音,僅有濕啰音.新生兒RSV下呼吸道感染易閤併細菌感染.有特應性傢族史患兒RSV下呼吸道感染時更易齣現喘息,RSV感染後更易齣現反複咳喘.
목적 탐토신생인호흡도합포병독(RSV)하호흡도감염적림상특점,급기여환인출원후반복해천적관계.방법 선취2008년5월지2013년5월우북경신세기인동의원진단위RSV하호흡도감염적신생인,대환인림상자료급출원후수방결과진행분석.결과 공납입41례RSV하호흡도감염신생인.41례균유해수증상,38례(92.7％)유창내,13례(31.7％)유발열,27례(65.9％)환인폐부유천명음;12례(29.3％)합병세균감염,최상견위금황색포도구균(50.0％,6/12례).RSV병세균감염조환인(12례)발열비례고우단순RSV감염조(29례),차이유통계학의의(x2 =6.034,P＜0.05),이백세포총수급흉편유편영2조간차이무통계학의의(x2=0.859、2.064,P=0.485、0.202).유특응성가족사적환인여무특응성가족사적환인비교,RSV하호흡도감염시경역출현천식(88.2％비57.1％,x2 =4.871,P＜0.05).출원후수방,환인출현반복해수화/혹천식조여무반복해수화/혹천식조비교,전자유특응성가족사자비례경고(71.4％비26.3％,x2=6.388,P＜0.05).결론 신생인RSV하호흡도감염다표현위해수、창내、부분환인폐부사체가무천명음,부유습라음.신생인RSV하호흡도감염역합병세균감염.유특응성가족사환인RSV하호흡도감염시경역출현천식,RSV감염후경역출현반복해천.
Objective To investigate the clinical features of neonatal lower respiratory tract infection (LRTI)with respiratory syncytial virus(RSV),and to explore the relationship between clinical features and recurrcnt cough or wheezing after discharge.Methods From May 2008 to May 2013,the data of 41 neonates diagnosed as LRTI with RSV infection in New Century International Children's Hospital were analyzed retrospectively.The clinical features and follow-up results were observed.Results All the neonates had cough,92.7％ (38/41 cases) had choking,85.4％ (35/41 cases) had runny nose and nasal obstruction,31.7％ (13/41 cases) had fever,65.9％ (27/41 cases) had wheezing sound during physical examination,29.3％ (12/41 cases)of the neonates were accompanied with bacterial infection(n=29),in which 50.0％ (6/12 cases) were infected by staphylococcus aureus.Compared to the neonates only with RSV infection,the proportion of fever was higher in those with RSV combined with bacterial infection (n =12)(x2 =6.034,P ＜ 0.05),and there were no statistical differences between the neonates with or without bacterial infection in white blood cell count and with or without shadow in chest X-ray(x2 =0.859,2.064,P =0.485,0.202).Compared with the neonates without family history of atopy,the neonates with the family history of atopy were more likely to get wheezing (88.2％ vs 57.1％,x2 =4.871,P ＜ 0.05) during primary infection.During the follow-up,there was higher proportion of children with family history of atopy in the group with subsequent recurrent cough and/or wheezing than in the group without subsequent recurrent cough and/or wheezing (71.4％ vs 26.3％,x2 =6.388,P ＜ 0.05).Conclusions Cough,choking are most common symptoms in neonatal LRTI with RSV,and there is no wheezing sound during phy-sical examination in some neonates.LRTI with RSV is likely combined with bacterial infection.Wheezing is more common in the neonates with family history of atopy.The RSV LTRI neonates with family history of atopy incline to get subsequent recurrent cough or wheeze after discharge.
