无症状儿童下呼吸道的呼吸道病毒感染。
Respiratory viral infection in lower airways of asymptomatic children.
机构信息
Respiratory Research Group, Centre for Infection and Immunity, Queen's University of Belfast, Belfast, UK.
出版信息
Acta Paediatr. 2010 Mar;99(3):394-8. doi: 10.1111/j.1651-2227.2009.01627.x. Epub 2009 Dec 9.
AIM
The aim of this study was to determine if asthmatic children have viruses more commonly detected in lower airways during asymptomatic periods than normal children.
METHODS
Fifty-five asymptomatic children attending elective surgical procedures (14 with stable asthma, 41 normal controls) underwent non-bronchoscopic bronchoalveolar lavage. Differential cell count and PCR for 13 common viruses were performed.
RESULTS
Nineteen (35%) children were positive for at least one virus, with adenovirus being most common. No differences in the proportion of viruses detected were seen between asthmatic and normal 'control' children. Viruses other than adenovirus were associated with higher neutrophil counts, suggesting that they caused an inflammatory response in both asthmatics and controls (median BAL neutrophil count, 6.9% for virus detected vs. 1.5% for virus not detected, p = 0.03).
CONCLUSIONS
Over one-third of asymptomatic children have a detectable virus (most commonly adenovirus) in the lower airway; however, this was not more common in asthmatics. Viruses other than adenovirus were associated with elevated neutrophils suggesting that viral infection can be present during relatively asymptomatic periods in asthmatic children.
目的
本研究旨在确定无症状期哮喘儿童下呼吸道病毒的检出率是否高于正常儿童。
方法
55 例择期手术的无症状儿童（14 例哮喘稳定儿童，41 例正常对照儿童）接受非支气管镜肺泡灌洗。进行了细胞差异计数和 13 种常见病毒的 PCR 检测。
结果
19 名（35%）儿童至少有一种病毒阳性，其中腺病毒最常见。哮喘儿童和正常“对照组”儿童之间未发现检测到的病毒比例存在差异。除腺病毒以外的病毒与较高的中性粒细胞计数相关，提示它们在哮喘患者和对照组中均引起炎症反应（检测到病毒的 BAL 中性粒细胞中位数为 6.9%，未检测到病毒的 BAL 中性粒细胞中位数为 1.5%，p = 0.03）。
结论
超过三分之一的无症状儿童下呼吸道存在可检测到的病毒（最常见的是腺病毒）；然而，哮喘儿童中这种情况并不更常见。除腺病毒以外的病毒与升高的中性粒细胞相关，提示在哮喘儿童相对无症状期也可能存在病毒感染。
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