The Study Of Viral Pathogen And Pulmonary Function In Infants With Bronchiolitis

Objective:To investigate the condition of viral pathogen of infants under 1 year with bronchiolitis in Children’s Hospital Affiliated to Suzhou University.To provide evidences for clinical diagnosis and disease assessment by comparing tidal breathing pulmonary function to investigate the changes in pulmonary function of infants with bronchiolitis,and the correlation with the severity.Method:Retrospective investigating 343 hospitalized infants with bronchiolitis aged from 1 months to 1 years old in the Department of respiration of Children’s Hospital Affiliated to Suzhou University from January 2016 to December 2016.The general clinical data of infants was collected,including age,sex,onset season,feeding quantity,respiratory rate,inspiratory depression,flaring of nares or groan,mental condition,and transdermal oxygen saturation.Nasopharyngeal secretions were obtained within twenty-four hours after admission.Respiratory syncytial virus(RSV),adenovirus(ADV),influenza virus A(IV-A),influenza virus B(IV-B)and Para influenza virus type 1-3(PIV-1-PIV-3)were detected by direct immunofluorescence assay.Human Boca Virus(HBoV)was detected by fluorescence quantitative PCR while Human rhinovirus(HRV)and human metapneumovirus(HMPV)were detected by reverse transcription PCR(RT-PCR).Detecting the tidal breathing pulmonary function on 218 cases of bronchiolitis and 20 cases of normal controls(by Jaeger MasterScreen)and grouping the cases according to the age of onset,the incidence of seasons,moderate to severe bronchiolitis pathogens.Results:(1)Virus etiology analysis:It was found that the total positive rate was 45.48%.Among the virus,top detected Virus was RSV(positive rate was 29.15%),followed by HRV(positive rate was 13.99%).Infants with bronchiolitis within 1 year of age increased with age,RSV detection rate decreased gradually.The infection rate of bronchiolitis in different seasions:the rate of infection in winter is higher than that in spring and summer.RSV summer infection rate was the lowest,only 1.85%,the highest winter infection rate,up to 47.10%;HRV summer infection rate was the highest,up to 31.48%,the lowest winter infection rate,only 5.80%.(2)Pulmonary function:The levels of Ti/Te,TPTEF,TPTEF/TE,VPEF/VE were significantly decreased in the bronchiolitis group,RR was increased,the difference was statistically significant,VT/kg was no significant difference.Compared with HRV group,RR significantly increased Ti/Te and TPTEF reduced in RSV group.Bronchiolitis more serious condition,RR faster more obvious,TPTEF/TE and VPEF/VE lower more obvious.Conclusion:(1)RSV is the main pathogen of children with bronchiolitis.HRV also occupies an important position.The incidence rate of RSV infection in 1-3 month old group was the highest.Infants with bronchiolitis within 1 year of age increased with age,RSV detection rate decreased gradually.The viral infection rate of bronchiolitis in winter is higher than that in sprirng and summer.RSV infection rate was the lowest in summer,the highest in winter;HRV infection rate was the highest in summer,the lowest in winter.(2)The pulmonary function of children with bronchiolitis showed a small airway obstruction,and RR,Ti/Te,TPTEF,TPTEF/TE and VPEF/VE were hypersensitive.(3)the lung injury of infants infected with RSV were more severed than those infected with HRV.(4)The tidal breathing pulmonary function test can be used to assess the severity of bronchiolitis.