115例新生儿呼吸道合胞病毒肺炎临床及流行特征分析

目的分析新生儿呼吸道合胞病毒(RSV)肺炎临床及流行病学特征,为治疗和预防RSV肺炎提供依据。方法对2012年3月~2013年2月住院的115例RSV(+)肺炎患儿临床资料进行分析,并与同时期住院的RSV(-)肺炎患儿的临床特征进行比较。结果调查的428例住院新生儿感染性肺炎中RSV(+)共115例,阳性分离率为26.9%,高峰期在4~6月份。经χ2检验,RSV阳性组与阴性组相比差异有统计学意义(P0.05)的临床指标有:接触史(17.4%vs9.9%)、咳嗽(87.8%vs 31.0%)、鼻塞流涕(82.6%vs 27.8%)、痰鸣音(61.7%vs 24.3%)、细湿罗音(44.2%vs 15.7%)和母乳喂养(39.1%vs 53.4%)。RSV(+)肺炎患儿中有10例出现混合感染,其中感染肺炎支原体6例,感染肺炎克雷伯杆菌2例,感染金黄色葡萄球菌2例。所有RSV(+)患儿经采用支持对症给氧等治疗后,均达出院标准。结论 RSV是引起新生儿感染性肺炎的重要病原体,尤其是病毒性肺炎的首位病原体,好发于春夏季。部分RSV(+)患儿可合并其他病原体感染,感染后治疗效果较好。

Clinical and epidemiological features of 115 neonates with respiratory syncytial virus pneumonia

Objective To analyze the clinical and epidemiological features of neonatal respiratory syncytial virus （RSV） infections . Methods The clinical data of 115 RSV（＋）neonatal pneumonia cases were analyzed, and the RSV（-）neonatal pneumonia infectious were compared at the same time and the clinical signs were compared. Results The postive rate of RSV was 26.9% among 428 neonatal pneumonia case and the infection reached at peak from April to June, Six indicators of touching RSV（17.4% vs 9.9%）,cough（87.8% vs 31.0%）,runny nose（82.6% vs 27.8%）,phlegrn song（61.7% vs 2413%）,fine tales （44.2% vs 15.7%）and breast feeding（39.1% vs 53.4%）.10 showed significant differences between the two groups. Mixed infections were noticed in ten cases RSV （＋）cases, including 6 cases infected with Mycoplasma pneumoniae, 2 cases infected with Klebsiella pneumoniae and two infected with Staphylococcus aureus . All RSV--positive children were discharged after supportive treatment with oxygen symptomatic treatment. Conclusion RSV is the most important pathogen of neonatal pneumonia infectious and the infection caused by this pathogen usually occurs in spring and summer. Some RSV-positive child cases might have co-infections due to other pathogen but the clinical outcome is good.