随着小儿其它急性传染病的控制,急性呼吸道感染(ARI)已列居感染性疾病的首位。引起ARI 的病原大约80～90%为病毒(发展中国家细菌性比例较高),其次是细菌。而支原体、霉菌、原虫等也能引起ARI。为指导基层临床治疗,概括为三种情况,即病毒感染、细菌感染和病毒、细菌混合感染。现将基层儿科工作者如何鉴别诊断谈几点体会。一、病史重点应注意以下几点。1.年龄与发病季节:病毒感染主要侵犯小年龄组,7～14岁显著减少;而细菌特别是支原体则随年龄增长而增加。混合感染特别多见于婴幼儿,其发病率较学龄儿童高3倍以上,而肺炎的发病率则大42倍。腺病毒3型引起咽结合膜热多发生于春季,柯萨奇A 组病毒引起的疱疹性咽峡炎多发生在夏秋季,而轮状病毒引起的感染高峰在晚秋,流感病毒流行季节多集中在冬末春初,而鼻 With the control of other acute infectious diseases in children, acute respiratory infections (ARIs) are already at the top of infectious diseases. Approximately 80-90% of ARI-causing pathogens are viruses (higher bacterial counts in developing countries), followed by bacteria. Mycoplasma, mold, protozoa, etc. can also cause ARI. To guide the primary clinical treatment, summarized in three cases, namely, viral infections, bacterial infections and viruses, mixed bacterial infections. Now the primary pediatric workers how to differential diagnosis talk about a few experiences. First, the history should focus on the following points. 1. Age and season of onset: virus infection mainly infringes on the small age group, 7 to 14 years significantly reduced; and bacteria, especially mycoplasma increased with age. Mixed infections are more common in infants and young children, the incidence of more than 3 times higher than school-age children, while the incidence of pneumonia is 42 times larger. Adenovirus type 3 cause pharyngeal conjunctival fever occurs mostly in the spring, Coxsackie A virus caused by herpes angina most occurred in summer and autumn, and rotavirus infection caused by the peak in late autumn, the flu season mostly concentrated in the winter and spring Early, while the nose