舟山市婴幼儿急性呼吸道病毒感染病原学分析

Study on viral pathogen in infants and young children with acute respiratory infection in Zhoushan Archipelago

目的探讨浙江省舟山市婴幼儿急性呼吸道病毒感染的病原学特点。方法采集2004年4月～2008年11月因急性呼吸道感染而住院治疗的1217例患儿痰液,用直接荧光法检测呼吸道合胞病毒（RSV）、腺病毒（ADV）、流感病毒A、B型（IFVA、B）、副流感病毒Ⅰ、Ⅱ、Ⅲ型（PIV Ⅰ、Ⅱ、Ⅲ）共7种病毒抗原。结果1217例患儿鼻咽分泌物中病毒抗原检测阳性360例,阳性率29.58%;所检病毒依次为RSV（17.50%）、ADV（5.67%）、IFV A（2.88%）、IFV B（1.39%）、PIV Ⅰ（0.74%）、PIV Ⅱ（1.07%）和PIV Ⅲ（0.33%）。〈3个月患儿组病原检测阳性率最高为45.67%,随着患儿年龄的增大,阳性率逐渐降低;冬春季节病毒抗原阳性率与夏秋季相近;毛细支气管炎患儿病毒阳性率明显高于急性支气管炎、急性支气管肺炎和上呼吸道感染。结论呼吸道合胞病毒（RSV）感染仍是舟山市婴幼儿急性呼吸道病毒感染最常见的病原,喘息性疾病感染率较高。

Objective To study virus infection state in infants and young children suffered with acute respiratory infection in Zhoushan Archipelago. Methods Nasopharyngeal secretion was obtained from 1217 in-patient children diagnosed as acute respiratory infection between April 1 st,2004 and November 30th,2008, and respiratory syncytial virus （ RSV）, adenovirus, para influenzavirus Ⅰ, Ⅱ , Ⅲ and influenza virus A, B were detected by direct immunofuorescence asssay. Results Of 1217 samples,360 samples （29.58%） were shown to be viral positive,of which,RSV accounted for 213 （17.50%） ,ADV 69 （5,67%）,IFVA35 （2.88%）,IFVB 17 （1.39%）,Pig Ⅰ9 （0.74%）,PIV Ⅰ 13 （1.07%）,and PIV Ⅲ4 （0.33%） respectively. The virus positive rate was the highest in 〈3 months group （45.67%） ,and the positive rate decreased gradually with the increase of children＇ s age. The virus positive rate in winter and spring was similar to that of in the summer and autumn. There was a higher virus detection rate in children with bronchiolitis than in those with acute bronchitis, acute bronchial pneumonia and upper respiratory tract infection. Conclusion RSV was the most common pathogens in infants and young children suffering from acute respiratory infection in Zhoushan Archipelago. The virus infection rates in young childre with asthmatic disease was higher. The diagnosis of viral pathogens should be strengthened to provide a reliable evidence for clinical diagnosis and treatment.