儿童哮喘急性发作时人鼻病毒感染率的临床刍议

杨祎++徐云芳++张春生

[摘要] 探讨人鼻病毒所致哮喘的发病机制，为寻找该病的病因及发病机制提供依据。 方法 通过便利抽样法选取2015年10月—2016年4月于溧阳市人民医院儿科住院治疗的哮喘急性发作期患儿92例作为试验组，同时选取同期健康儿童30名作为对照组。采用酶联免疫法检测血清中的HRV感染情况。以HRV检测结果将试验组分为HRV阳性组和HRV阴性组。结果 试验组中HRV阳性者为64例，阳性率为69.57%；HRV阴性者为28例（30.43%）。对照组未检测出HRV阳性者，试验组阳性率显著高于对照组（P<0.01）。试验组HRV阳性的血白细胞计数（15.78±3.89）109/L、中性粒细胞比例（0.98±0.01）、CRP浓度（14.32±2.11）mg/L和平均住院天数（9.54±3.20）d与HRV阴性[（9.88±2.67）×109/L、（0.52±0.22）、（9.56±3.23）mg/L、（6.21±2.40）d]相比后，差异有统计学意义（P<0.01）。结论 哮喘发作期患儿人鼻病毒感染率明显高于正常儿童，提示HRV感染与哮喘的急性发作有关。

[关键词] 儿童哮喘；人鼻病毒（HRV）；感染；酶联免疫法

[中图分类号] R725.6 [文献标识码] A [文章编号] 1674-0742（2017）05（b）-0017-03

[Abstract] Objective To discuss the pathogenesis of asthma caused by the human rhinovirus and provide basis for the cause and pathogenesis. Methods 92 cases of children during the acute asthma attack period from October 2015 to April 2016 were selected as the test group， while 30 cases of healthy children at the same period were selected as the control group， and the serum HRV infection situation was tested by the enzyme-linked immunosorbent assay， and the test group were divided into the HRV positive group and HRV negative group according to the HRV test results. Results In the test group， there were 64 HRV positive cases， and the positive rate was 69.57%， and there were 28 HRV negative cases， and the negative rate was 30.43%， and the HRV positive patients were not tested in the control group， and the positive rate in the test group was obviously higher than that in the control group（P<0.01）， and the differences in the blood white cell count， neutrophil ratio， CRP concentration and average length of stay between the HRV positive patients and the HRV negative patients were statistically significant[（15.78±3.89）×109/L， （0.98±0.01）， （14.32±2.11）mg/L， （9.54±3.20）d vs （9.88±2.67）×109/L， （0.52±0.22）， （9.56±3.23）mg/L， （6.21±2.40）d]. Conclusion The human rhinovirus infection rate of children at the acute asthma attack is obviously higher than that of normal children， which reminds that the HRV infection is related to the acute attack of asthma.

[Key words] Asthma in children； HRV； Infection； Enzyme-linked immunosorbent assay

隨着社会的高速发展，人类的生活模式逐渐改变，全世界范围内哮喘患者逐年增多。支气管哮喘是气道的一种慢性变态反应性炎症性疾病，由多种诱发因素（如：感染，过敏源等）导致肥大细胞，嗜酸细胞，淋巴细胞等多种炎症细胞介导的气道炎症，以反复喘息、咳嗽、气促，胸闷为主要临床表现。由于儿童哮喘发病机制复杂，呼吸道病毒诱导哮喘发作可能有多种不同方式，目前尚不能完全明确，当前尚无有效的治疗和预防人鼻病毒的药物，最近成功开发α-ketoamide蛋白酶抑制剂可能对人鼻病毒有一定的作用[1]，该文通过酶联免疫分析（ELISA）法检测当地哮喘患儿血清中HRV（抗原）的感染情况，为该疾病寻找新型有效的治疗方法提供依据，该研究主要对该院2015年10月—2016年4月期间的122例儿童进行探析，现报道如下。

1 资料与方法

1.1 一般资料

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