急性下呼吸道感染患儿呼吸道合胞病毒及其亚型的检测及分析

Detection and analysis of RSV and its subgroups in infants with acute lower respiratory tract infection.

目的 总结呼吸道合胞病毒(RSV)在其流行季节的亚型分布情况;探讨RSV亚型和临床疾病严重程度的相关性。方法 采用RT PCR 酶联夹心杂交法检测了2 0 0 2年1 0月至2 0 0 3年3月和2 0 0 3年1 0月至2 0 0 4年3月连续两年冬春季期间就诊于温州医学院附属儿童医院的2 0 2例急性下呼吸道感染的婴幼儿鼻咽部分泌物中RSV及其亚型;结合临床资料,对临床症状和体征进行疾病严重程度评分。结果 2 0 2例标本中RSV阳性共1 2 3例,阳性检出率为60 . 9% ;两个冬春季都以RSVA亚型为主,2 0 0 2～2 0 0 3年冬春季A亚型占RSV阳性标本中76 7% ,2 0 0 3～2 0 0 4年占82. 0 % ;通过对97例A亚型和2 6例B亚型病例临床资料的评估,发现B亚型引起的临床症状和体征更重(P <0. 0 5)。结论 RSV是引起冬春季婴幼儿急性下呼吸道感染的最主要的病原体;以A亚型为主,但B亚型引起的临床表现更严重。

Objective To analyze the epidemics and distributive situations of RSV subgroups A and B in infants with acute lower respiratory tract infections in the south area of Zhejiang and to explore the relationship between RSV subgroups and the severity of clinical symptoms. Methods The RSV subgroups A and B in the nasopharyngeal aspirates(NPAs) obtained from 202 infants with acute lower respiratory tract infection at Children’s Hospital of Wenzhou Medical College over two successive winters and springs of 2002～2003 and 2003～2004 were randomly detected with RT-PCR-enzyme-linked sandwich hybridization(RT-PCR-ELSH). A severity index of clinical symptoms and signs was used to grade illness severity. Combining the illness severity score with the results of RT-PCR-ELSH, the relationship between respiratory syncytial virus strain and disease severity was explored.Results Of the 202 samples,123 (60.9%)were positive for RSV. RSV subgroup A predominated in these two successive winters and springs of 2002～2003 and 2003～2004 (76.7%, 82.0% of RSV positive samples, respectively).In this study , the clinical data of 97 cases of subgroup A and 26 subgroup B indicated that the clinical symptoms and the signs caused by subgroup B may be more severe than that by subgroup A , but this conclusion will be confirmed by more cases in subsequent studies.Conclusions RSV is the major pathogen of acute lower respiratory tract infections among infants in winter and spring in the south area of Zhejiang.Subgroup A predominate ,but subgroup B may cause more severe illness than subgroup A considering clinical symptoms and signs.