苏州地区急性呼吸道感染儿童中副流感病毒的研究

Parainfluenza virus infection in pediatric patients with acute respiratory infections in Suzhou district

目的了解近6年来苏州地区儿科急性呼吸道感染中副流感病毒（PIV）的感染状况。方法用直接免疫荧光法（DFA）对13793份急性呼吸道感染患儿鼻咽分泌物标本进行PⅣ等病毒抗原检测。结果（1）2001-2006年PIV全年阳性检出率依次是10．32％、4．69％、2．68％、2．17％、3．26％和0．81％；PIV感染四季均可流行，无明显季节差异；（2）急性上呼吸道感染PIV1占14．38％，PIV2占11．76％，PIV3占4．73％，三亚型间差异具有统计学意义（P〈0．01）；急性下呼吸道感染PIV1占78．13％、PIV2占76．47％、PIV3占89．05％，三亚型间差异也具有统计学意义（P〈0．01）；（3）2岁以内婴幼儿PIV感染PIV3显著高于PIV1及PIV2（P〈0．01），2岁以上组PIV1和PIV3两亚型感染率无差异（P〉0．05），但均高于PIV2（P〈0．05）。结论苏州地区PIV流行无明显季节性；三亚型均以急性下呼吸道感染为主，但以PIV3比例最高；PIV1和PIV2相对以急性上呼吸道感染常见；2岁以内婴幼儿PIV感染以PIV3多见，PIV1感染年龄分布偏向2岁以上儿童。

Objective To investigate the relationship of parainfluenza virus （PIV） with acute respiratory infections in pediatric patients in Suzhou district occurred in recent six years. Methods PIV was identified by direct immunofluorescence assay （DFA） from nasopharyngeal secretions of 13 793 cases with acute respiratory infections. Results There was an epidemic of PIV during four seasons of a year. The positive rates were 10. 32%,4.69%,2.68%,2.17%,3.26% and 0. 81% for the year of 2001 to 2006, respectively. The percentage of upper respiratory tract infections was 14.38% in 160 PIV1 positive cases, 11.76% in 68 PIV2 positive cases and 4. 73% in 338 PIV3 positive cases （χ^2 = 14. 473, P〈0.01）. The percentage of lower respiratory tract infections was 78. 13% in 160 PIV1 positive cases, 76.47% in 68 PIV2 positive cases and 89.05% in 338 PIV3 positive cases（χ^2 =13. 955,P〈0.01）. The infectious rate of PIV3 was higher than that of PIV1 or PIV2 in 2 years old infants（χ^2=80. 984,P〈0. 01;χ^2 =38. 578,P〈0. 01）. There was no significant difference in the infectious rate between PIV1 and PIV3 in the greater than 2 years old groups （χ^2 = 0.116, P〉0.05;χ^2 = 0. 631, P〉0. 05）, which was all higher than that in PIV2 （χ^2 =7. 239, P〈0.05 χ^2=12.977,P〈0.01）. Conclusion The epidemic of PIV has no seasonal significance in Suzhou district. The three subtypes of PIV causing infections were mainly in lower respiratory tract. PIV1 and PIV2 are more common in causing upper respiratory tract infections, and PIV3 is more common in causing lower respiratory tract infections. The children within 2 years old is more ofter infected by PIV3, and those greater than 2 years old by PIV1.