Azevedo A M N, Durigon E L, Okasima V, Queiroz D A O, de Moraes-Vasconcelos D, Duarte A J S, Grumach A S
Medical School, University of São Paulo, Brazil.
Allergol Immunopathol (Madr). 2003 Nov-Dec;31(6):311-7. doi: 10.1016/s0301-0546(03)79204-0.
Viral upper respiratory tract infections (URTI) have been correlated with the onset of asthma attacks in children and viral identification was reported in 14-49 % of nasal samples. The aim of the present study was to detect influenza, parainfluenza, adenovirus and respiratory syncytial virus (RSV) in older children during acute asthma attacks.
A total of 104 children (2-14 years) were included in four groups: group I: asthmatics with acute attack and URTI; group II: asthmatics without URTI (group I children, 30 days later); group III: non-asthmatics with URTI; group IV: non-asthmatic, asymptomatic children. A diagnosis of URTI was considered when (3 symptoms (cough and/or sneeze, nasal obstruction, hypertrophy of turbinates, pain and/or retropharynx hyperemia, headache and fever) in asthmatics and at least 2 symptoms in non-asthmatics were present, starting within 7 days. Samples of nasal mucosa cells (n = 123) were collected, and culture and indirect immunofluorescence were carried out to identify respiratory syncytial virus, adenovirus, influenza A and B, parainfluenza 1,2 and 3 and rhinovirus.
Viral identification rates were higher in the asthmatic groups: 13.9 % in group I, 11.1 % in group II; 2.8 % in group III and 0 in group IV. The following viruses were identified: RSV 2/36, rhinovirus 1/36, adenovirus 1/36 and parainfluenzae 1/36 in group I; adenovirus 2/18 in group II; RSV 1/36 in group III.
The rate of viral identification was higher in asthmatic children, whether symptomatic or not, suggesting a possible susceptibility to viral infections. Virus could also be a triggering factor in attacks, although it is not the most preponderant in older children.
病毒性上呼吸道感染（URTI）与儿童哮喘发作有关，据报道在14%至49%的鼻样本中可检测到病毒。本研究的目的是在大龄儿童急性哮喘发作期间检测流感病毒、副流感病毒、腺病毒和呼吸道合胞病毒（RSV）。
共有104名2至14岁的儿童被纳入四组：第一组：患有急性发作和URTI的哮喘儿童；第二组：无URTI的哮喘儿童（第一组儿童，30天后）；第三组：患有URTI的非哮喘儿童；第四组：非哮喘无症状儿童。当哮喘儿童出现3种症状（咳嗽和/或打喷嚏、鼻塞、鼻甲肥大、疼痛和/或咽后壁充血、头痛和发热）且非哮喘儿童至少出现2种症状，且症状在7天内开始出现时，可诊断为URTI。收集鼻黏膜细胞样本（n = 123），并进行培养和间接免疫荧光检测，以鉴定呼吸道合胞病毒、腺病毒、甲型和乙型流感病毒、副流感病毒1、2和3以及鼻病毒。
哮喘组的病毒检出率较高：第一组为13.9%，第二组为11.1%；第三组为2.8%，第四组为0。在第一组中鉴定出以下病毒：呼吸道合胞病毒2/36、鼻病毒1/36、腺病毒1/36和副流感病毒1/36；第二组中鉴定出腺病毒2/18；第三组中鉴定出呼吸道合胞病毒1/36。
无论有无症状，哮喘儿童的病毒检出率都较高，提示其可能易受病毒感染。病毒也可能是发作的触发因素，尽管在大龄儿童中并非最主要的因素。
