苏州市5岁以下儿童呼吸道合胞病毒感染的临床特征和影响因素

目的  分析呼吸道合胞病毒(respiratory syncytial virus, RSV)感染住院儿童的临床特征，探究其影响因素。方法  通过医院信息系统筛选2010-2014年期间于苏州大学附属儿童医院住院的5岁以下急性下呼吸道感染(acute lower respiratory infection, ALRI)病例，从病历中收集ALRI住院病例的临床诊治、生化检测资料，通过实验室检测信息系统获取其RSV检测结果。比较RSV阳性和阴性ALRI病例的临床特点，采用非条件Logistic回归分析模型分析RSV感染的影响因素。结果  19 257名ALRI病例中，4 096例RSV检测结果阳性，阳性率为21.3%。RSV阳性ALRI患儿的常见症状为咳嗽(99.4%)、咽痛/咽红(98.3%)、喘息(60.9%)。与RSV阴性患儿相比，RSV阳性患儿喘息、气促发生率均较高(均有P＜0.001)，发热率低(χ² =280.8，P＜0.001)。低年龄是RSV感染的独立危险因素，与24~＜60月龄儿童相比，1~＜6月龄、6~＜12月龄、12~＜24月龄儿童感染RSV的调整比值比分别为4.00(95% CI: 3.57~4.48)、2.60(95% CI: 2.30~2.94)、1.82(95% CI: 1.59~2.07)。结论  RSV感染患儿喘息、气促的发生率较高；低年龄是RSV感染的独立危险因素，年龄越小，感染RSV的风险越高。

Analysis of clinical characteristics and influencing factors of respiratory syncytial virus infection among children under 5 years old in Suzhou

  Objective  To analyze the clinical characteristics of hospitalized children with respiratory syncytial virus (RSV) infection and explore the influencing factors in RSV infection.  Methods  First of all, the Hospitalization Information System was applied to retrospectively screened the children with acute lower respiratory infection (ALRI) who got hospitalized in Suzhou University Affiliated Children's hospital (SCH) from 2010 to 2014. Then, the detailed data in relation to their clinical diagnosis, treatment and biochemical test was collected from the medical records of ALRI inpatient and the results of their RSV tests were obtained from the Laboratory Information System. Upon a comparison drawn in clinical characteristics between RSV positive and negative ALRI cases, non-conditional Logistic regression model analysis was performed to analyze the influencing factors in RSV infection.  Results  Among the 19 257 ALRI cases involved, 4 096 were positive for RSV, with a positive rate of 21.3%. The common symptoms exhibited by RSV-infected children include coughing (99.4%), sore throat (98.3%) and wheezing (60.9%). Compared with RSV-negative patients, RSV-positive ALRI patients had higher symptom rates in respect of wheezing and shortness of breath (all P < 0.001), but lower symptom rates with regard to fever (χ2 =280.8, P < 0.001). Young age was identified as an independent risk factor of RSV infection. In comparison with those children aged 24- < 60 months, the adjusted odds ratio for RSV infection among the children aged 1- < 6, 6- < 12, and 12- < 24 months reached 4.00 (95% CI: 3.57-4.48), 2.60 (95% CI: 2.30-2.94) and 1.82 (95% CI: 1.59-2.07), respectively.  Conclusions  The children with RSV infection have higher symptom rates of wheezing and shortness of breath. Young age is an independent risk factor for RSV infection, which means the younger the age, the higher the risk of RSV infection.