温州育英儿童医院急性下呼吸道感染住院患儿病毒病原学研究

Investigation on the viral etiology of acute lower respiratory tract infection in Wenzhou Yuying children's hospital

目的探讨急性下呼吸道感染住院患儿病毒病原学情况,及其与年龄、呼吸道疾病的关系。方法选择温州医学院附属育英儿童医院2003年1月～2005年1月因急性下呼吸道感染住院治疗的儿童2073例,取其鼻咽分泌物,采用直接荧光免疫法检测7项呼吸道病毒抗原,分析其结果。结果2073例患儿送检标本,阳性1006份,阳性率48.5%。阳性标本中呼吸道合胞病毒(RSV)798例(79.3%),副流感病毒Ⅲ型(PIVⅢ)106例(10.5%),腺病毒(ADV)31例(3.0%),流感病毒A型(IVA)26例(2.6%),流感病毒B型(IVB)6例(0.6%),副流感病毒Ⅰ型(PIVⅠ)15例(1.5%)、RSV和IVA混合感染18例(1.8%),RSV和PIVⅢ混合感染3例(0.3%),RSV和PIVⅠ混合感染3例(0.3%),PIVⅡ未检测到。结论温州地区急性下呼吸道感染以RSV为主要病原,婴幼儿(尤其<6个月)病毒感染率较高,好发于冬春季节,以急性毛细支气管炎的检出率最高(61.3%)。

Objective To study the infectious state of virus in children suffered from acute lower respiratory tract infection from Janurary 2003 to Janurary 2005 in Wenzhou area. Methods Patients suffering from acute lower respiratory tract infection（ALRI） who were admitted to the Affiliated YuYing Children＇s Hospital of Wenzhou Medical College from Janurary 2003 to Janurary 2005 were chosen. Their nasopharyngeal secretions（NPS） were obtained for identification of seven kinds of respiratory viral antigens by direct immunofluorescence assay. Results Among the all 2073 samples, 1006 （48.5 % ） positive results were determined. Of the 1006, respiratory syncytial virus （ RSV ） accounted for 798 （ 79. 3 % ）, parainfluenza Ⅲ （ PIV Ⅲ ） 106（ 10. 5 % ） , adenoviruses （ADV） 31 （3.0%） , influenza virus A（IVA） 26 （2. 6% ） , influenza virus B 6（0. 6% ） ,parainfluenza Ⅰ 15（ 1.5% ） ,RSV and IVA mixed infection 18（ 1.8% ） ,RSV and PIV Ⅲ 3（0. 3% ） , RSV and PIV Ⅰ 3（0. 3 % ）. Conclusion RSV infections are dominant in ALRI in Wenzhou, followed by PIV Ⅲ. The most respiratory viral infections occur in children between 1 and 6 months. In addition, most bronchiolitis and severe pneumonia are caused by respiratory virus.