Clinical Characteristics Of Children With Respiratory Syncytial Virus Infection And Changes In Cytokines

Objective:By researching the clinical characteristics of child with the respiratory syncytial virus(RSV)infection and obeserve the changes of the level of cytokines IL-1β、IL-2、IL-6、IL-8 and TNF-α in serum.so as to provide some basis for clinical diagnosis and treatment.and to explore the immune pathological mechanism of RSV infection.Methods:Between January 2021 and December 2021,112 children who were hospitalized in the respiratory department of Changchun Children’s Hospital due to acute respiratory tract infection and diagnosed with simple RSV infection were collected as the observation group,and 100 healthy children were selected as the control group for the study.The clinical date were obtained from the observation group.The observation group were divided into the mild group and the severe group according to the severity of the RSV infection.Also the observation group were divided into the wheezing symptoms group and non-wheezing symptoms group based on wheezing symptoms.Analyze the clinical characteristics of children with solely RSV infection.Analyze five cytokines(IL-1β、IL-2、IL-6、IL-8 and TNF-α)in peripheral blood of children with RSV infection and 100 normal controls.Analyze the relationship between the level of cytokines and the illness condition of the children with RSV infection,and analyze the relationship between the level of cytokines and the wheezing symptoms.Results:1.General situation of RSV infection,gender distribution:there are 60 males and 52 females.There was no significant difference in the probability of the different genders(χ2=0.571,P=0.450).Age Distribution:In 112 solely RSV infection children,≤6 months of age 23.21%(26/112),6<M≤12 months age 16.96%(19/112),12<M≤24 months age 21.43%(24/112),24<M≤36 months age 14.29%(16/112),36<M≤48 months age 13.39%(15/112),>48 months age 10.72%(12/112).The age ≤24 months accounted for 61.6%(69/112).2.Seasonal distribution of RSV infection:30(26.78%)in spring,3(2.68%)in summer,19(16.96%)in autumn and 60(53.58%)in winter.3.After RSV infection happend,the children may exhibit some symptoms includes coughing(98.21%),wheezing(65.79%),fever(32.14%),dyspnoea(19.64%),stuffy and runny nose(10.71%),cyanosis(8.93%).And wheezes(65.79%),moist rales(36.61%)and dry rales(13.39%)can be heard by auscultation of the lungs.In the observation group,WBC count increased of 23 cases(20.53%),and no change of 78 cases(69.65%)and reduced of 11 cases(9.83%);The NEUT%increased of 19 cases(16.96%),LYM%increased of 73 cases(65.18%);The elevated hs-CRP was 19 cases(16.96%).The chest radiographs may manifest increased texture(32.14%),scattered patchy shadows(38.39%),large shadows or solid changes(4.46%)and manifestations of emphysema pulmonum(16.07%).The clinical diagnosis includes acute laryngitis(1.79%),lobar pneumonia(4.46%),acute upper respiratory tract infection(5.3 6%),acute bronchitis(13.39%),bronchopneumonia(33.93%)and bronchi oliti s(41.07%).4.The levels of IL-1β、IL-2、IL-6、IL-8 and TNF-α of the control group,the mild group and the severe group were increased in sequence,and there was significant differences among the three groups(P<0.05).The severity of the children with RSV infection was positively correlated with IL-6、IL-8 and TNF-α(P<0.05).5.IL-6 and TNF-α levels were significantly elevated in RSV-infected infants with wheezing symptoms compared with RSV-infected infants without wheezing symptoms(P<0.05).Conclusion:1.There are no significant difference in the gender among the children with RSV infection.RSV infection usually occurs in infants under 6 months old.2.The prevalence of RSV infection is mainly concentrated in winter and spring.3.The most prominent clinical manifestation of the children with RSV infection is cough and wheezing,and wheezes and moist rales can be heard on lung auscultation.4.The peripheral blood lymphocyte count is relatively high in children with RSV infection.Scattered patchy shadows and increased texture on chest radiographs are the common clinical characteristic.5.The main disease caused by RSV infection is bronchiolitis,then followed by bronchopneumonia.6.Cytokines such as IL-1β、IL-2、IL-6、IL-8 and TNF-α play vital roles in immunopathogenesis of RSV infection.7.The relationship between the severity of RSV infection and IL-6、IL-8 and TNF-αHorizontal positive correlation.8.IL-6 and TNF-α are involved in the pathogenesis of wheezing in infants with RSV infection.