广州市不同时段成人上呼吸道感染病毒鉴定与临床分析

Clinical analysis and identification of virus infected from upper respiratory in different time quantum in Guangzhou.

目的探讨广州市成人上呼吸道感染不同时段的病毒分布。方法收集2007年5月至2008年12月广州医学院第一附属医院发热门诊与呼吸疾病研究所门诊患者咽拭子,用PCR法、RT-PCR法、荧光RT-PCR法、抗原胶体金法、病毒分离培养法进行病毒检测。结果284份标本确诊为病毒感染的标本43份,阳性率为14.8%。混合感染的患者8例(18.6%)。引起广州市2007—2008年上呼吸道感染的主要病毒是腺病毒(ADV),ADV感染所致的上呼吸道感染多发生于6、7月份,以2007年明显。2008年春季主要是甲型流感病毒(IFA),其次是乙型流感病毒(IFB),其余时间主要是ADV(30.2%),其次是呼吸道合胞病毒(RSV,4.7%)。血常规显示,外周血白细胞计数、中性粒细胞计数、单核细胞计数、血小板计数均降低,与对照组相比差异有统计学意义(P<0.05)。结论广州市2008年春季上呼吸道感染的主要病毒是IFA,其次是IFB,其余时间主要是ADV,其次是RSV,副流感病毒1型感染。荧光PCR法检测病毒比较客观,适合临床病毒检测。

Objective To approach the distribution of virus infected from upper respiratory of adults in different time. Methods The pharyngal swabs which were from the patients in out-patient clinic of pyrexia and out-patient clinic of respiratory institute were detected by PCR, RT-PCR, fluorescenee-PCR, antigen gold colloid and viral isolation culture methods. Results The major viruses cause upper respiratory infection in Guangzhou from 2007 to 2008 was ADV, the upper respiratory infection caused by ADV occurred mainly in June and July, especially in 2007.43 examples were positive out of 284 examples, the rate of positive was 14. 8%. 8 patients were multiply infected which was 18. 6% among the positive ones. IFA virus were the major virusis in the spring in 2008, the next was IFB virus. Adenovirus was the major for the rest among those detected, which was 30. 2% ;the 2nd was RS virus ,4. 7 % respectively. Blood routine examinations demonstrated that the counts of WBC, neutrophil, monocyte and platelet were decreased. There were significant differences in the results between two groups（ P 〈 0.05 ）. Conclusion IFA virus is the major virusis in the spring in 2008, the next is IFB virus. Adenovirus is the major for the rest among those detected, the next is RS virus. Fluorescenee-PCR is comparetively objective in virus detection and suitable for clinical.