住院儿童常见呼吸道病毒抗原检出情况分析

Detection of common respiratory virus antigens in hospitalized children

目的了解江西省萍乡市妇幼保健院急性呼吸道感染住院患儿呼吸道病毒病原流行病学特征。方法回顾性分析2018-07至2019-06在萍乡市妇幼保健院住院的急性呼吸道感染患儿7656例的病例资料,采用直接免疫荧光法检测患儿鼻咽分泌物中7种常见呼吸道病毒的抗原。7种常见呼吸道病原体包括呼吸道合胞病毒,甲型流感病毒,乙型流感病毒,副流感病毒Ⅰ、Ⅱ、Ⅲ型,腺病毒。结果7656例患儿中,病毒的阳性检出率为25.57%,检出率排名前三的病毒为:呼吸道合胞病毒(13.39%),腺病毒(4.79%),甲型流感病毒(3.24%)。各年龄组患儿病毒检出情况:<1岁组30.11%,1~<3岁组25.79%,3~<6岁21.80%,≥6岁16.08%,年龄越小患儿病毒检出率越高,不同年龄组病毒阳性检出率差异存在统计学意义。呼吸道合胞病毒在<1岁组患儿中检出率最高21.51%,腺病毒在3~<6岁组患儿中检出率最高10.27%。不同性别阳性检出率差异不存在统计学意义。RSV、IFVA感染集中在冬春季,ADV、IFVB感染集中在4-6月,其他病毒呈全年散发。检出12例(0.16%)2种病毒协同感染。结论病毒是儿童急性呼吸道感染的主要病原,了解本地区呼吸道感染病毒的流行病学对临床诊疗工作有指导意义。

Objective To find out about the epidemiological characteristics of respiratory viruses in hospitalized children with acute respiratory infections in Pingxiang Maternal and Child Health Hospital.Methods The clinical data of 7656 children with acute respiratory tract infection hospitalized between July 2018 and June 2019 in Pingxiang Maternal and Child Health Hospital was analyzed retrospectively.The antigens of seven common respiratory viruses in nasopharyngeal secretions of children were detected by direct immunofluorescence assay.These seven common respiratory pathogens included respiratory syncytial virus,influenza virus A,influenza virus B,parainfluenza virusⅠ,Ⅱ,Ⅲand adenovirus.Statistical analysis of data was conducted using SPSS19.0 software.Results In the 7,656 cases,the positive rate of at least one virus was 25.57%.The top three viruses were respiratory syncytial virus(13.39%),adenovirus(4.79%)and influenza A virus(3.24%).The rate of virus detection was 30.11%in the group under1 year old,25.79%in the group aged 1 to less than 3,21.80%in the group aged 3 to less than 6 and 16.08%in the group aged 6 or above.The younger the age,the higher the detection rate of virus.There was difference of statistical significance in the positive rate of virus between these age groups.The highest detection rate of respiratory syncytial virus was 21.51%in children less than 1 year old and 10.27%in children less than 6 years old.There was no significant difference in the positive rate of the seven viruses between different genders.The incidence of RSV and IFVA infections was the highest in winter and spring,compared with April and June for ADV andIFVB.Other viruses were distributed throughout the year.Twelve of these cases(0.16%)were co-infected with two kinds of viruses.Conclusions Virus is the main pathogen of acute respiratory tract infections in children.The identification of the epidemiology of respiratory tract infection viruses in this area can guide clinical diagnosis and treatment.