741例儿童急性呼吸道感染病毒病原学研究

Study on viral pathogen of acute respiratory infection in 741 children

目的了解2003—2004年重庆地区儿童急性呼吸道感染病毒病原在季节、呼吸道疾病、年龄、性别方面的差异，为临床提供相应的治疗和预防措施。方法对741例住院确诊急性呼吸道感染的患儿抽取其鼻咽分泌物，采用直接免疫荧光法检测7种病毒即呼吸道合胞病毒（RSV）、腺病毒、副流感病毒Ⅰ、Ⅱ、Ⅲ、流感病毒A、B。结果儿童急性呼吸道感染病毒病原的总阳性率与季节、呼吸道疾病、年龄有关，与性别无关。冬季、毛细支气管炎、29d至6个月婴幼儿病毒检出率最高，春季、上感、3岁以上儿童病毒检出率最低。在7种感染病毒中，以RSV占首位，阳性率为87．3％，其次递减为副流感病毒Ⅲ、腺病毒、流感病毒A。其中RSV在0—6个月、毛细支气管炎患儿中检出率最高，3岁以上、上感儿童检出率最低；腺病毒常见于夏季、上感、3岁以上、女性儿童；流感病毒A则多见于夏季、上感儿童。结论通过检测儿童呼吸道感染疾病的病毒病原，不仅可对临床提供快速、准确的诊断依据，防止滥用抗生素。对临床表现无特异性者，还可通过季节、疾病、年龄等流行病学资料来鉴别病毒病原，必要时应进行病毒抗体或病毒血清学检查，以便治疗和预防，降低病毒感染率。

Objective To study the difference between season, respiratory disease, age and sex in viral pathogens of acute respiratory infection （ARI） of children in Chongqing during 2003 - 2004 to provide strategy for clinical treatment and precaution. Methods Nasopharyngeal secretion was obtained from 741 in-patient children diagnosed as ARI, and respiratory syncytial virus （RSV） , para influenza virus Ⅰ , Ⅱ,Ⅲ, adenovirus and influenza virus A, B were detected by direct immunofluorescence. Results There was relationship between total positive rate of virus pathogens of children＇ s ARI and season, respiratory disease and age, but not for sex. Positive rate of virus was highest in winter, bronchiolitis and infants aged 29 days - 6 months, lowest in spring, upper respiratory infection and children over 3 years. Among the 7 virus, top detected virus was RSV （positive rate was 87.3% ）, followed in turn by para influenza virus Ⅲ, adenovirns, influenza virus A. There was highest RSV detection rate in infants aged 0 -6 months with bronchiolitis, and lowest in children over 3 years with upper respiratory infection. Adenovirus was commonly detected in summer, and girls over 3 years with upper respiratory infection, and influenza virus A commonly in summer and children with upper respiratory infection （URI）. Conclusion Detection of viral pathogens in children with respiratory infection could give fast, accurate diagnostic evidence, and help avoid antibiotics abuse. Viral kinds could be estimated by epidemiologic features such as season, disease and age etc. Antiviral antibody and other detection should be done if necessary for facilitating the treatment and precaution of ARI.