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1、RespiratoryDiseasesGeneralIntroductionRespiratorydisordersimportantasTheyaccountfor50%ofconsultationswithgeneralpractitionersforacuteillnessinyoungchildrenandathirdofconsultationsinolderchildrenRespiratoryillnessleadsto20-35%ofacutepaediatricadmissionstohospital

2、,someofwhicharelife-threateningAsthmaisthemostcommonchronicillnessofchildhoodintheworldAcuteUpperRespiratoryInfection(AURI)IntroductionAURIsarethemostfrequentlyoccurringillnessinchildren.Onaverage,childrenacquirethreetoeightAURIseveryyear.AURIsaregenerallycaused

3、bytheviruses.Therearelittledifferenceintheincidenceofcoldsbysex,race,orgeograhpicregion.Environmentalfactorsthatincreasethelikelihoodofacquiringcoldincludeattendanceatchildcarefacilities,smoking,passiveexposuretosmoke,lowincome,crowdingandpsychologicstress.Etiol

4、ogyVirusesColdvirusesmaybetransmittedbythreeroutes:Large-particledroplets,whichcantravelashortdistancetodirectlyinoculateanotherpersonSmall-particleaerosols,whichcantravellongerdistancesanddepositdirectlyinalveoliofotherindividualsSecretion,whicharetransmittedby

5、directphysicalcontactEtiologyCommonvirusesthatusuallycausecommoncoldsRhinovirusesParainfluenzaorinfluenzavirusesRespiratorySyncytialVirus(RSV)CoronavirusesAdenovirusEnterovirusesCoxsackieVirusandECHOVirusReovirusesEtiologyThecommoncoldhasover200knownviralcauses:

6、30%arerhinoviruses.40%areunknown.15%areinfluenzaorparainfluenzaviruses.10%arecoronaviruses.(20%inadult.)5%areenteroviruses.EtiologyParainfluenzaviruses(types1～4)oftenproducelowerrespiratorydiseasebut,particularlyinreinfections,thesymptomsmaypresentasuncomplicate

7、dAURIs.RSVoftenbeginsininfantsasaAURIbutspreadstothelowerrespiratorytract.EtiologyBacteriaAbacteralinfectionissecondary.Themostcommonbacteria:StreptococcushemolyticusInfluenzaBacillusStreptococcusPneumoniaeMycoplasmaPneumoniaeEtiologyOthercausesCharacteristicofr

8、espiratoryanatomyandphysiologyinchildrenCharacteristicofrespiratoryimmunityinchildrenBodystates:DeficiencyofvitaminsandtraceelementsmalnutritionEnvironmentalfactorsPa