重庆地区人类偏肺病毒感染与小儿毛细支气管炎

Study on the clinical characteristic pattern of infantile bronchiolitis associated with human metapneumovirus infection hMPV in Chongqing area

目的探讨人类偏肺病毒(humanmetapneumovirus,hMPV)在重庆地区小儿毛细支气管炎中的感染情况,比较hMPV与呼吸道合胞病毒(RSV)感染引起的毛细支气管炎的临床特点。方法用免疫荧光快速诊断方法,检测80例毛细支气管炎患儿鼻咽分泌物中RSV、腺病毒(Ado)、流感病毒(Flu)A、B、副流感病毒(Para)1、2、3七种常见呼吸道病毒,采用RT?PCR的方法检测上述患儿鼻咽分泌物中hMPV的L基因和M基因。结果80例毛细支气管炎患儿鼻咽分泌物中病毒检出率为65%,在病毒阳性检出标本中RSV感染占63.4%(33/52例),Flu?B(3/52例)和Para?3(3/52例)均占5.77%,Para?1占1.92%(1/52例),Flu?A与Flu?B混合感染占3.85%(2/52例);80例患儿的鼻咽分泌物中发现10例为hMPVL和M基因同时阳性,其中单独hMPV阳性7例,3例为RSV与hMPV合并感染,hMPV阳性占病毒阳性检出标本的13.46%(7/52例),hMPV与RSV合并感染为5.77%(3/52例)。结论RSV仍然是引起毛细支气管炎的首位病原,约为41.25%;hMPV感染在重庆地区小儿毛细支气管炎中居第二位,约占8.75%(7/80例),仅从临床表现上很难鉴别hMPV感染与RSV感染。

Objective Human metapneumovirushMPV is a newly discovered pathogen associated with childhood bronchiolitis. In order to study the incidence of hMPV infection in childhood bronchiolitis in Chongqing area and the clinical characteristic pattern of such childhood bronchiolitis in comparison with that associated with RSV infection. MethodsRSV,adenovirusAdo,influenza virusFlu A and B,parainfluenza virusPara 1,2,3,associated with respiratory disorders from nasopharyngeal secretion in 80 infants with bronchiolitis were assayed with rapid immunofluorescence method. At the same time,the L and M gene of hMPV were also detected with RT-PCR. Results The positive rate of the virus infection identified in the nasopharyngeal secretion from 80 infants with bronchiolitis was 65%52/80. Of them,the RSV infection accounted for 63.4%33/52,FluB3/52 and Para-33/52 accounted for 5.77% seperately,while Para-1 for 1.92%1/52 and mixed infection of FluA and B accounted for 3.85%2/52. Whereas hMPV L and M genes could be identified simultaneously in 10 of 80 infants with bronchiolitis. Among them only hMPV was discovered in 7 infants while the combined infection of RSV and hMPV was found in 8 infants. So,The hMPV positive rate identified accounted for 13.46%9/52 in all the samples having positive virus finding with mixed infection of hMPV and RSV accounting for 5.77%3/52. ConclusionsThese data suggested that the first pathogen associated with childhood bronchiolitis still were RSV.While hMPV infection allocated in second position in infant with bronchiolitis in Chongqing area accounting for 8.75% approximately7/80. So, it's difficult to differentiat hMPV infection from RSV infection just according to the clinical manifestation.