肖志刚 李隐民

【摘要】目的：探讨新生儿呼吸道合胞病毒（RSV）感染的特点，为新生儿 RSV 感染的防控提供数据参考。方法：选择2017年1月至2019年10月在梅州市妇幼保健计划生育服务中心新生儿科拟诊为下呼吸道感染633例患儿作为研究对象，观察患儿RSV 发生率及发病特征。结果：633例下呼吸道感染患儿中 RSV 确诊146例，检出率为23.06%。随着患儿日龄增加， RSV 感染患儿发病率显著增加，组间比较差异有统计学意义（P <0.05）。RSV 感染冬春季高发，夏季和秋季发病很低，差异有统计学意义（P <0.05）。进一步分析显示，1月和2月发病率最高，其次是11月和12月。RSV 和非 RSV 患儿年龄、性别、出生体质量、咳嗽、喘息、呼吸困难、紫绀、拒伤、喘鸣音、白细胞、C 反应蛋白、肝酶异常、肌酸激酶异常等相比较差异无统计学意义（P >0.05）， RSV 感染患儿早产、呼吸急促、湿啰音、胸片异常、细菌感染发生率高于非 RSV 组患儿，发热率低于非 RSV 患儿，差异有统计学意义（P <0.05）。经对症处理和支持治疗，所有患儿均符合出院标准。结论： RSV 感染是本地区住院新生儿下呼吸道感染的重要病因，多发于冬春季节，随着新生儿年龄增加，发病率呈升高趋势，对新生儿下呼吸道感染进行干预时，应根据患儿病情特征考虑 RSV 感染的可能并进行针对性干预，以改善患儿临床结局。

【关键词】呼吸道合胞病毒;新生儿;下呼吸道感染;临床特征

【中图分类号】R722.1【文献标识码】A 【文章编号】2096-5249（2021）22-0013-03

Clinical analysis of 146 cases of neonatal respiratory syncytial virus

Xiao Zhi-gang， Li Yin-min

Meizhou Maternal and Child Health Care and Family Planning Service Center， Pediatrics，Meizhou，514021， China

【Abstract】Objective：To explore the characteristics of neonatal respiratory syncytial virus（RSV）infection and provide data for the prevention and control of RSV infection. Methods：From January 2017 to October 2019，633 children with lower respiratory tract infection were selected as the study objects，and the incidence and characteristics of RSV were observed.Results：Among 633 children with lower respiratory tract infection，146 cases were con?rmed RSV，the detection rate was 23.06%.With the increase of age，the incidence of RSV infection increased signi?cantly（P<0.05）.RSV infection was higher in winter and spring，but lower in summer and autumn（P<0.05）.Further analysis showed that the highest incidence was in January and February，followed by Novem- ber and December.There were no signi?cant di?erence in age，sex，birth weight，cough，wheezing，dyspnea，cyanosis，injury rejec- tion，wheezing，leukocyte，C-reactive Protein，liver enzyme and creatine kinase between RSV and non RSV children（P>0.05）. The incidence of Premature delivery，shortness of breath，moist rales，abnormal chest radiograph and bacterial infection in children with RSV infection was higher than that in children without RSV infection，and the fever rate was lower than that in children without RSV infection，with statistical signi?cance（P<0.05）.After symptomatic treatment and supportive treatment，all the children met the discharge standard.Conclusion：RSV infection is an important cause of lower respiratory tract infection in hospitalized neonates in this area，which mainly occurs in winter and spring.With the increase ofthe age ofthe newborn，the incidence is increasing.In or- der to improve the clinical outcome，we should consider the Possibility ofRSV infection according to the characteristics of children's condition.

【Key Words】Respiratory syncytial virus;Newborn;Lower respiratory tract infection;Clinical characteristics

呼吸道合胞病毒（RSV）是世界范围内婴幼儿最常见的呼吸道病毒，是导致急性细支气管炎和病毒性肺炎的常见病原体，也是世界范围内仅次于疟疾的第二大新生儿死亡病因[1]。流行病学调查显示， RSV感染每年导致340万人住院，60万人死亡，最常见于24个月以下儿童，新生儿因为免疫功能尚未完备，来自母体的抗体不是RSV 的易感人群，在新生儿确诊为肺炎病例中， RSV 占重要比例，与新生儿的死亡率显著相关[2]。目前对新生儿RSV感染尚未特效治疗，探讨新生儿，RSV感染的临床特征对其防控具有重要意义[3]。本研究通过2017年1月至2019年10月在梅州市妇幼保健计划生育服务中心确诊的 RSV新生儿进行观察，探讨患儿的临床特征，现将结果报告如下。

1对象与方法

1.1研究对象

选择2017年1月至2019年10月在梅州市妇幼保健计划生育服务中心新生儿科拟诊为毛细支气管炎或肺炎等下呼吸道感染患儿作为研究对象。……