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[小儿呼吸道合胞病毒和人偏肺病毒所致社区获得性肺炎的临床特征分析]

[Analysis of clinical features of community-acquired pneumonia caused by pediatric respiratory syncytial virus and human metapneumovirus].

作者信息

Okada Takafumi, Matsubara Keita, Matsushima Takahiro, Komiyama Osamu, Chiba Nahoko, Hamano Keiko, Morozumi Miyuki, Ubukata Kimiko, Sunakawa Keisuke, Iwata Satoshi

机构信息

Department of Pediatrics, National Hospital Organization Tokyo Medical Center.

出版信息

Kansenshogaku Zasshi. 2010 Jan;84(1):42-7. doi: 10.11150/kansenshogakuzasshi.84.42.

Abstract

We retrospectively reviewed the background, clinical features, blood tests, and complications in the 720 children seen for acute respiratory tract infection from July 2004 to December 2005. Of these, 75 (10.5%) were diagnosed with pneumonia due to respiratory syncytial virus (RSV) and 19 (2.6%) with pneumonia due to human metapneumovirus (hMPV) based on multiplex PCR analysis of nasopharyngeal samples. RSV was PCR-positive mostly in winter, -from November to January-, and hMPV mostly in spring, -from March to June. The mean RSV pneumonia group age was 1.3 +/- 1.4 years and in the hMPV pneumonia group 3.0 +/- 3.1 years, showing a statistically significant differences in the age of virus onset. Clinically the RSV group showed more rhinorrhea and wheezing (p < 0.05) and the hMPV group a higher maximum body temperature and a longer wheezing duration (p < 0.05). Fever, cough, vomiting, diarrhea, fever frequency, and C-reactive protein level were similar in both groups (p > 0.05). Complication prevalence was 49.3% in the RSV group and 42.1% in the hMPV group. Acute otitis media was seen more often in the RSV group (32.0%) and febrile convulsion more often in the hMPV group (15.8%) (p > 0.05). These findings may be helpful in clinically diagnosing community-acquired pneumonia due to RSV or hMPV.

摘要

我们回顾性分析了2004年7月至2005年12月期间因急性呼吸道感染就诊的720例儿童的背景、临床特征、血液检查及并发症情况。其中,基于对鼻咽样本的多重聚合酶链反应(PCR)分析,75例(10.5%)被诊断为呼吸道合胞病毒(RSV)肺炎,19例(2.6%)被诊断为人偏肺病毒(hMPV)肺炎。RSV PCR检测阳性大多出现在冬季(11月至1月),而hMPV大多出现在春季(3月至6月)。RSV肺炎组的平均年龄为1.3±1.4岁,hMPV肺炎组为3.0±3.1岁,两组病毒发病年龄差异有统计学意义。临床上,RSV组流涕和喘息症状更多(p<0.05),hMPV组最高体温更高且喘息持续时间更长(p<0.05)。两组的发热、咳嗽、呕吐、腹泻、发热频率及C反应蛋白水平相似(p>0.05)。RSV组并发症发生率为49.3%,hMPV组为42.1%。RSV组急性中耳炎更为常见(32.0%),hMPV组热性惊厥更为常见(15.8%)(p>0.05)。这些发现可能有助于临床诊断由RSV或hMPV引起的社区获得性肺炎。

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