摘要
目的:总结人博卡病毒(HBoV)感染导致塑型性支气管炎(PB)的临床特征,为诊疗提供参考。方法:回顾2例经靶向下一代测序(t NGS)确诊的HBoV-PB患儿资料,并系统检索CNKI、万方、维普、PubMed、Google Scholar和Web of Science数据库,归纳临床表现、影像特点、病原检测、治疗及转归等。结果:2例患儿均以发热、咳嗽起病,其中1例伴喘息、气促,对常规抗感染、雾化及祛痰治疗无效。胸部影像示肺不张和/或实变,气管镜提示PB,t NGS检测到HBoV。共纳入文献11篇,包括32例HBoVPB患儿,男女比例3.57∶1,年龄10个月~5岁,18.8%有过敏史。主要表现为发热、咳嗽、气促、喘息和进行性呼吸困难;单一HBoV感染占81.3%。32例均行胸片/CT,78.1%见肺不张,43.8%见实变,12.5%见支气管狭窄或闭塞;16例病理显示纤维蛋白伴嗜酸粒细胞浸润,3例有夏科-雷登晶体。所有患儿预后良好,无并发症。结论:婴幼儿若出现发热、咳嗽、重度喘息及进行性呼吸困难,且CT提示肺不张或气道黏液栓,应警惕HBoV-PB。t NGS有助于明确病原,支气管镜对诊疗至关重要。
Objective:To summarize the clinical characteristics of plastic bronchitis(PB)induced by human bocavirus(HBoV)infection,and provide guidance for diagnosis and treatment.Methods:Clinical data of 2 children with HBoV-PB diagnosed by targeted next-generation sequencing(tNGS)were reviewed,and literature from CNKI,Wanfang,VIP,PubMed,Google Scholar and Web of Science databases were systematically retrieved to summarize the clinical manifestations,imaging characteristics,pathogen detection,treatment and prognosis.Results:Both cases presented with fever and cough,one case had wheezing and dyspnea,standard antibiotics,nebulization,and expectorants failed.Imaging showed atelectasis and/or consolidation,bronchoscopy confirmed PB,tNGS identified HBoV.A total of 11 articles were enrolled,and 32 cases of HBoV-PB were reported.The ratio of male to female was 3.57∶1.The age ranged from 10 months to 5 years,and 18.8%had a history of allergy.The main manifestations were fever,cough,dyspnea,wheezing and progressive respiratory distress,isolated HBoV infection accounted for 81.3%.Chest X-rays/CT were performed in 32 cases.And 78.1%showed atelectasis,43.8%showed consolidation,and 12.5%showed bronchial obstruction or stenosis.The pathology of 16 cases showed fibrin with eosinophil infiltration,and 3 cases had Charcot-Reden crystals.All patients had good prognosis and no complications.Conclusion:For infants with fever,cough,severe wheezing and progressive respiratory distress,and CT indicates atelectasis or airway mucus plugs,HBoV-PB should be vigilant.tNGS is helpful for pathogen identification,and bronchoscopy is crucial for diagnosis and treatment.
作者
陈洪佳
夏万敏
黄懿洁
Chen Hongjia;Xia Wanmin;Huang Yijie(The Affiliated Women’s and Children’s Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu Women’s and Children’s Central Hospital,Chengdu 611731,China)
出处
《儿科药学杂志》
2025年第6期37-40,共4页
Journal of Pediatric Pharmacy
基金
2023年四川省自然科学基金(青年基金项目)
编号2023NSFSC1469。
关键词
塑型性支气管炎
儿童
人博卡病毒
靶向下一代测序
plastic bronchitis
children
human bocavirus
targeted next-generation sequencing
