Wu Pei-Qiong, Li Xing, Jiang Wen-Hui, Yin Gen-Quan, Lei Ai-Hua, Xiao Qiang, Huang Jian-Jun, Xie Zhi-Wei, Deng Li
Department of Respiration, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623 People's Republic of China.
Institute of Human Virology, Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan 2nd Road, Guangzhou, 510080 People's Republic of China.
Springerplus. 2016 Sep 20;5(1):1622. doi: 10.1186/s40064-016-3237-7. eCollection 2016.
Bronchiolitis obliterans (BO) is an uncommon and severe sequela of chronic obstructive lung disease in children that results from an insult to the lower respiratory tract. Few prognostic factors achieved worldwide acknowledgment. In the present study, we retrospectively collected the children with respiratory adenoviral infection and identified the predictive factors of BO. In the period between Jan 2011 and December 2014, the consecutive in-hospital acute respiratory infection children with positive result for adenovirus were enrolled into the present study. High resolution computerized tomography and clinical symptoms were utilized as the diagnostic technique for BO. Multivariate analysis using a Logistic proportional hazards model was used to test for independent predictors of BO. A total of 544 children were included with 14 (2.57 %) patients developed BO. Compared with children without BO, BO children presented higher LDH (523.5 vs. 348 IU/ml, = 0.033), lower blood lymphocyte count (2.23 × 10/L vs. 3.24 × 10/L, = 0.025) and higher incidence of hypoxemia (78.6 vs. 20.8 %, = 0.000). They presented relatively persistent fever (15.5 vs. 7 days, = 0.000) and needed longer treatment in hospital (19.5 vs. 7 days, = 0.000). Concerning treatment, they were given more intravenous γ-globulin (85.7 vs. 36.8 %, = 0.000), glucocorticoids (78.6 vs. 24.3 %, = 0.000) and mechanical ventilation (35.7 vs. 5.5 %, = 0.001). Multiple analyses determined that hypoxemia was the only independent predictor for BO. The present study identified hypoxemia as the independent predictive factor of BO in adenoviral infected children, which was a novel and sensitive predictor for BO.
闭塞性细支气管炎（BO）是儿童慢性阻塞性肺疾病一种罕见且严重的后遗症，由下呼吸道损伤引起。很少有预后因素得到全球认可。在本研究中，我们回顾性收集了呼吸道腺病毒感染患儿并确定了BO的预测因素。在2011年1月至2014年12月期间，连续住院的腺病毒检测结果呈阳性的急性呼吸道感染患儿被纳入本研究。高分辨率计算机断层扫描和临床症状被用作BO的诊断技术。使用逻辑比例风险模型进行多变量分析以测试BO的独立预测因素。共纳入544名儿童，其中14名（2.57%）患儿发生了BO。与未发生BO的儿童相比，发生BO的儿童乳酸脱氢酶水平更高（523.5对348 IU/ml，P = 0.033），血淋巴细胞计数更低（2.23×10⁹/L对3.24×10⁹/L，P = 0.025），低氧血症发生率更高（78.6%对20.8%，P = 0.000）。他们发热相对持续时间更长（15.5天对7天，P = 0.000），住院治疗时间更长（19.5天对7天，P = 0.000）。在治疗方面，他们接受更多静脉注射γ-球蛋白（85.7%对36.8%，P = 0.000）、糖皮质激素（78.6%对24.3%，P = 0.000）和机械通气（35.7%对5.5%，P = 0.001）。多因素分析确定低氧血症是BO的唯一独立预测因素。本研究确定低氧血症是腺病毒感染儿童BO的独立预测因素，这是一种针对BO的新型且敏感的预测因素。
