儿童急性下呼吸道感染病毒病原学分析

Analysis of viral pathogen in children with acute lower respiratory tract infections

目的了解儿童急性下呼吸道感染病毒病原学特点。方法采用直接免疫荧光法(DIF),对2007年9月—2009年9月住院的5480例0～12岁下呼吸道感染患儿鼻咽分泌物进行8种病毒检测。结果5480例患儿中,2710例检出至少1种病毒,总检出率49.5%。呼吸道合胞病毒(RSV)检出最多,为1386例,占51.1%,其余,依次是偏肺病毒(hMPV)513例(18.9%),副流感病毒Ⅲ(PIVⅢ)338例(12.5%),腺病毒(ADV)192例(7.1%);流感病毒A(IFA)128例(4.7%),流感病毒B(IFB)79例(2.9%),副流感病毒Ⅰ(PIVⅠ)41例(1.5%),副流感病毒Ⅱ(PIVⅡ)33例(1.2%)。6个月以下年龄组阳性率最高,为43.5%。RSV、hMPV季节性较明显,主要集中在冬春季节(11月至次年4月)。肺炎、毛细支气管炎、支气管炎(伴喘息)、支气管炎(不伴喘息)和哮喘患儿病毒阳性率分别为47.4%、63.6%、50.5%、30.1%和43.5%。结论病毒是儿童急性下呼吸道感染的主要病原。发病年龄主要在婴幼儿,其中RSV和hMPV最常见。

Objective To elucidate the etiology feature of viral infection in hospitalized children with acute lower respiratory infection.Methods A total of 5480 children with acute lower respiratory tract infection,hospitalized from September 2007 to September 2009,were studied.Nasopharyngeal aspirates were screened for 8 types of viruses by direct immunofluorescence（DIF） assay.Results At least one type of viral pathogen was detected in 2710 out of 5480 patients and the overall positive rate was 49.5%.The most common virus was RSV（51.1%）,followed by hMPV（18.9%）,PIVⅢ（12.5%）,ADV（7.1%）,IFA（4.7%）,IFB（2.9%）,PIV I（1.5%） and PIVⅡ（1.2%）.The positive rate was highest in children under 6 months（43.5%）.The seasonal change of RSV、 hMPV was more obvious.The peak of RSV、 hMPV appeared in the winter and the spring.The prevalence of viral infection in children with pneumonia,bronchitis,asthmatic bronchitis,non asthmatic bronchitis and asthma were 47.4% 、 63.6% 、 50.5% 、 30.1% and 43.5% respectively.Conclusions Viruses are the main cause of lower respiratory tract infections in children,especially in infants and young children.RSV and hMPV were the most common viruses in these years.