Etiological Analysis Of Capillary Bronchitis In The District Of Baoding North And Beijing South

Objective: Bronchiolitis is one of the common lower respiratory tract infection for infants in winter and spring, with more obvious symptoms of asthma, dyspnea, sustained severe wheezing, respiratory difficulties, heart failure, respiratory failure and other complications which can be life-threatening compared with other pneumonia. The mortality rate of bronchiolitis in hospitalized children is 1%. The cause of capillary bronchitis is complicated which includes viral and mycoplasma infection of the respiratory tract, genetic factors, allergy(children having rashes and eczema, or getting RSV infection through breast feeding of allergic mothers), environmental pollution, rickets, malnutrition, premature birth, bronchopulmonary dysplasia, etc. According to the epidemiological research, the increasing mycoplasma infection in recent years such as RSV, adenovirus, influenza virus, parainfluenza virus, rhinovirus, human bokavirus and enterovirus can cause bronchiolitis which then induce wheezing. Bronchiolitis caused by RSV could easily change to pediatric asthma and mycoplasma infection could also induce asthma. Therefore, the incidence of pediatric asthma could be lowered by reducing the infection rate of bronchiolitis. The type of etiology causing capillary bronchitis varies with different countries, regions and seasons. Medicine for asthma and bronchiolitis induced by virus differs from that for wheezing caused by allergy. In recent years, the number of children with capillary bronchitis has been significantly increased in this area with different pathogens compared with other areas. Through investigation to the current condition of bronchiolitis etiology in the district of Baoding North and Beijing South, factors related to virus infection are analyzed so as to provide guidance of scientific prevention and treatment of capillary bronchitis among children.Method: 300 children with pediatric bronchiolitis were selected during December 2013 and April 2015 in our hospital in the district of Baoding North and Beijing South, including 169 boys and 131 girls, aged from one month to two years old, with average age of 1.06±0.45 years old, in which 180 cases were 1~6 months old, 100 cases were 6~12 months old and 20 cases were 1~2 years old. The pre-hospital disease course was 13 days with the average of 4.22±1.23 days. The inclusion criteria was: in accordance with the clinical diagnostic criteria in Zhu Futang Practical Pediatrics, having symptoms of coughing and wheezing, no fever or low fever, moderate fever, a few with higher fever, wheeze could be heard by lung auscultation, continuous wheezing, first and acute attack by the this disease and children's parents were informed and agreed. The clinical data of these 300 cases was analyzed including their age, gender, pre-hospital course of disease, main symptoms, laboratory examination, imaging examination, past history, allergic history and family history of allergy, treatment, prognosis and hospitalization time.Fasting venous blood samples of 3-5ml were collected from these children two times during 1-2 days and 7-10 days respectively after admission to hospital, before the respiratory virus antibody test was performed with the method of indirect immunofluorescence to detect the expression of virus antibody and mycoplasma pneumoniae antibody lgm. Positive result will be taken under the two following circumstances: results of both tests are positive, or the titers of antibody show the trend of rising.Results:300 cases had symptoms of coughing, wheezing and so on. The abnormal rate was 24.3% for blood, 11.3% for C-reflects protein, 7% for liver function and 11.3% for renal function(BUN). 54 out of 300 cases were positive with the mycoplasma pneumonia lgm, for which the positive rate was 18%. 150 cases were tested of viral infection, with the positive rate of 50%. The univariate analysis showed that there was an obvious correlation(P < 0.05) between capillary bronchitis virus infection and age, course of disease before admission, C-reactive protein and history of allergy. Multivariate analysis showed that age, pre-hospital course of disease and C-reactive protein were independent factors(P<0.05) associated with bronchiolitis virus infection.Conclusion:In the district of Baoding North and Beijing South, pathogenic investigation in children bronchiolitis shows that virus and mycoplasma infections are a major cause. Age, course of disease before admission and C-reactive protein are related to virus infection. Interventional treatment should be strengthened accordingly.