International Journal of Clinical Research
International Journal of Clinical Research. 2026; 10: (3) ; 10.12208/j.ijcr.20260139 .
总浏览量: 33
内蒙古科技大学包头医学院第一附属医院 内蒙古包头
*通讯作者： 经鑫爱,单位：内蒙古科技大学包头医学院第一附属医院 内蒙古包头; ；
目的 探究儿童重症呼吸道合胞病毒（RSV）感染的危险因素。方法 选择2023年8月至2024年12月于内蒙古科技大学包头医学院第一附属医院儿科住院的呼吸道合胞病毒感染260例患儿为研究对象，根据儿童社区获得性肺炎诊疗规范分为轻症组和重症组。收集纳入患儿的一般病史资料、体格检查指标及实验室检查指标，统计分析患儿RSV重症的危险因素。结果 260例RSV感染患儿按疾病严重程度分组，轻症组195例，重症组65例。两组患儿精神状况、呼吸频率、三凹征、鼻翼扇动、喘息比较，差异有统计学意义（P＜0.05）。经单因素及多因素Logistic 回归分析显示，呼吸频率、精神状况、三凹征、喘息均为疾病严重程度的独立影响因素（P＜0.05）。ROC曲线下面积为0.93[95%CI（0.89-0.98）]，特异性0.83，灵敏度0.85，提示预测效能良好。结论 呼吸频率、精神状况、三凹征、喘息是重症RSV感染的独立危险因素。
Objective To explore the risk factors of severe respiratory syncytial virus (RSV) infection in children. Methods A total of 260 children hospitalized in the Department of Pediatrics at the First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, from August 2023 to December 2024, with RSV infection were selected as the study subjects. According to the diagnostic and treatment guidelines for community-acquired pneumonia in children, they were divided into mild and severe groups. General medical history, physical examination indicators, and laboratory test indicators of the enrolled children were collected, and the risk factors for severe RSV infection were statistically analyzed. Results The 260 RSV-infected children were grouped by disease severity, with 195 in the mild group and 65 in the severe group. There were statistically significant differences in mental status, respiratory rate, tracheal retraction, nasal flaring, and wheezing between the two groups (P < 0.05). Univariate and multivariate logistic regression analysis showed that respiratory rate, mental status, tracheal retraction, and wheezing were independent influencing factors of disease severity (P < 0.05). The area under the ROC curve was 0.93 [95% CI (0.89-0.98)], with specificity of 0.83 and sensitivity of 0.85, indicating good predictive efficacy. Conclusion Respiratory rate, mental status, tracheal retraction, and wheezing are independent risk factors for severe RSV infection.
[1] GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet,2020,396(10258): 1204-1222.
[2] Li ZJ, Zhang HY, Ren LL, et al. Etiological and epidemiological features of acute respiratory infections in China[J]. Nat Commun, 2021,12(1):5026.
[3] 崔爱利,夏百成,朱贞,等. 2009—2023年中国16个省份急性呼吸道感染病例中人呼吸道合胞病毒的流行特征分析[J]. 中华预防医学杂志,2024,58(7):945-951.
[4] Zar HJ, Cacho F, Kootbodien T, et al. Early-life respiratory syncytial virus disease and long-term respiratory health[J]. Lancet Respir Med, 2024,12(10):810-821.
[5] Li Y, Wang X, Blau DM, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis[J]. Lancet, 2022,399 (10340):2047-2064.
[6] 国家呼吸系统疾病临床医学研究中心,中华医学会儿科学分会呼吸学组,中国医师协会呼吸医师分会儿科呼吸工作委员会,等. 儿童呼吸道合胞病毒感染诊断、治疗和预防专家共识[J]. 中华实用儿科临床杂志,2020,35(4): 241-250.
[7] 儿童社区获得性肺炎诊疗规范(2019年版)编写审定专家组. 儿童社区获得性肺炎诊疗规范(2019年版)[J]. 全科医学临床与教育,2019,17(9):771-777.
[8] 阿斯姆古丽•吾布力.儿童重症呼吸道合胞病毒性肺炎危险因素及临床特征分析[D].北京协和医学院,2020.
[9] 吴晓青. 呼吸道合胞病毒感染对小鼠肺内CFTR氯离子通道表达的影响[D]. 广东:汕头大学,2020.
[10] 龚成,王雪,罗明,等.重症呼吸道合胞病毒肺炎的危险因素分析[J].疾病监测,2020,35(07):613-617.
[11] 刘陶,张田圆,马琳,等. 呼吸道病毒感染中的免疫调节及临床治疗策略研究进展[J]. 中国免疫学杂志,2025,41(1): 231-240,245.
[12] 毕佳佳,邓广程,苏琪茹,等. 新生儿呼吸道合胞病毒急性下呼吸道感染的临床研究[J]. 中华实用儿科临床杂志, 2021,36(24):1871-1875.
[13] 李圆.2017～2022年儿童呼吸道合胞病毒肺炎流行病学研究及不良预后危险因素分析[D].广州医科大学,2023.