【摘要】 目的 :探讨重症社区获得性肺炎(CAP)患儿呼吸道病毒病原分布及危险因素。方法 :收集2008年9月～2011年2月(30个月)在湖南省人民医院(湖南师范大学附属第一医院)儿童医学中心住院儿童呼吸道鼻咽抽吸物样本(NAP),应用逆转录聚合酶链反应(RT-PCR)或PCR方法对12种常见呼吸道病毒进行检测。对儿童人口学、流行病学、临床资料和病毒类型进行多重Logistic回归分析,分析重症社区获得性肺炎(CAP)危险因素。结果 :1406名CAP住院儿童中,124例患者符合重症CAP诊断标准。61.3%(76/124)的重症CAP患者NAP样本至少检测到一种病毒,最常见的病毒是鼻病毒(26/124,21.0%),其次是腺病毒(19/124,15.3%)和呼吸道合胞病毒(19/124,15.3%);其中12.9%的样本(16/124)检测到两种及两种以上的病毒。对相关因素进行Logistic回归分析,其中基础疾病、腺病毒感染、甲型流感病毒感染是儿童重症CAP危险因素,而年龄增长和病毒混合感染是重症CAP保护性因素。结论 :鼻病毒、腺病毒和呼吸道合胞病毒是儿童重症CAP的常见病毒病原体;基础疾病、腺病毒感染、甲型流感病毒感染是儿童重症CAP危险因素,而年龄增长和病毒混合感染是其保护因素。更多还原

【Abstract】 Objective To investigate the respiratory viruses etiology and risk factors among children with severe community-acquired pneumonia(CAP), a retrospective study was conducted from September 2008 to February 2011(a period of 30 months). Method Reverse transcription polymerase chain reaction(RT-PCR) or PCR was employed to screen for twelve respiratory viruses innasopharyngeal aspirate specimens. Demographics, epidemiological data and virus types on the patients were analyzed by multivariate logistic regression analysis for examing risk factors for severe CAP. Result One hundred twenty-four cases were adimtted to hospital with severe CAP, and 76(61.3%) were detected at least one virus. The most commonly detected virus was human Rhinovirus(26, 21.0%), followed by Adenovirus(19, 15.3%) and respiratory syncytial virus(19, 15.3%). Sixteen of 124(12.9%) severe CAP were found more than one virus infected. Conclusion The presence of underlying disease, Adenovirus infection or influenza A infection were the risk factors for severe CAP in children, while elder age and viral co-infection were protective factors. This study suggested that respiratory virues were common etiologic agents of severe CAP in children.更多还原