儿科患者急性呼吸道感染的病因学与临床表现：俄罗斯莫斯科的一项回顾性研究
Etiology and Clinical Manifestations of Acute Respiratory Infections in Pediatric Patients: A Retrospective Study in Moscow, Russia.
文献信息
| PMID | 42783219 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Diana A Grigoryan |
| 作者单位 | Federal State Budgetary Institution "Centre for Strategic Planning and Management of Biomedical Health Risks" of the Federal Medical Biological Agency, Moscow 119121, Russia. |
| 期刊 | Diseases (Basel, Switzerland) |
| SCI 分区 | Q2 |
| IF | 3.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景/目的： 急性呼吸道病毒感染（ARVIs）是儿科发病的主要原因，并表现出相当大的临床异质性。分析临床与病因学关联，以及识别与重症ARVI病例相关的因素，对于有效的流行病学监测至关重要。
方法： 开展了一项回顾性、单中心观察性研究，纳入2021年至2024年间登记的1362例非COVID-19儿科急性呼吸道感染（ARIs）病例。使用实时PCR进行呼吸道病毒广谱筛查以检测病毒病原体。
结果： 约50%的病例确定了病毒病因。最常检测到的病原体是人鼻病毒（HRV）（35.6%），其次是呼吸道合胞病毒（RSV）和人腺病毒（HAdV）。尽管HRV占优势，但未表现出疾病分类学特异性。与下呼吸道感染最强的关联见于RSV（OR = 3.2）和人博卡病毒（HBoV；OR = 2.4），主要位于肺炎类别中。RSV还与支气管炎/细支气管炎相关（OR = 1.8）。与上呼吸道感染的显著关联见于流感病毒（OR = 10.4）和HAdV，包括鼻咽炎（OR = 3.88）和急性扁桃体炎（OR = 3.9）。HAdV还显示出与中耳炎的关联（OR = 5.1）。在所有临床观察中，52.3%登记为重症疾病，且最常发生在幼儿中，特别是与呼吸道合胞病毒（RSV >80%）以及人博卡病毒（HBoV）和人偏肺病毒（HMPV）（约55-59%）相关的病例。与单一感染相比，合并感染未与疾病严重程度增加相关（OR = 1.1）。
结论： 所获得的结果突出了特定病原体对儿童重症呼吸道感染的贡献。这些发现支持在临床诊断中优先考虑此类病原体，包括在儿科人群中设计诊断算法和选择患者管理策略。
英文摘要
BACKGROUND/OBJECTIVES: Acute respiratory viral infections (ARVIs) are the leading cause of pediatric morbidity and exhibit considerable clinical heterogeneity. The analysis of clinical and etiological associations, as well as the identification of factors linked to severe ARVI cases, is essential for effective epidemiological surveillance.
METHODS: A retrospective, single-center observational study was conducted including 1362 non-COVID-19 pediatric cases of acute respiratory infections (ARIs), registered between 2021 and 2024. Viral pathogens were detected using real-time PCR for broad-spectrum screening of respiratory viruses.
RESULTS: Viral etiology was established in approximately 50% of cases. The most frequently detected pathogen was Human rhinovirus (HRV) (35.6%), followed by Respiratory syncytial virus (RSV) and Human adenovirus (HAdV). Despite its predominance, HRV did not demonstrate nosological specificity. The strongest associations with lower respiratory tract infections were identified for RSV (OR = 3.2) and Human bocavirus (HBoV; OR = 2.4), predominantly within the pneumonia category. RSV was also associated with bronchitis/bronchiolitis (OR = 1.8). Significant associations with upper respiratory tract infections were established for Influenza viruses (OR = 10.4) and HAdV, including nasopharyngitis (OR = 3.88) and acute tonsillitis (OR = 3.9). HAdV additionally demonstrated an association with otitis media (OR = 5.1). Severe disease was registered in 52.3% of all clinical observations and occurred most frequently among young children, particularly in cases associated with respiratory syncytial virus (RSV >80%), as well as with human bocavirus (HBoV) and Human metapneumovirus (HMPV) (~55-59%). Co-infections were not associated with increased disease severity compared with monoinfections (OR = 1.1).
CONCLUSIONS: The obtained results highlight the contribution of specific etiological agents to severe respiratory infections in children. These findings support the prioritization of such pathogens in clinical diagnostics, including the design of diagnostic algorithms and the selection of patient management strategies in pediatric populations.