成人急性下呼吸道感染患者病毒病原学研究

Viral Etiology of Acute Lower Respiratory Infection in Adult Inpatients

目的了解成人下呼吸道感染住院患者呼吸道病毒病原学构成。方法深圳福田医院2007年10月至2008年10月临床诊断为社区获得性肺炎(CAP)、急性支气管炎(AB)、慢性阻塞性肺疾病急性加重(AECOPD)的住院患者为观察组,采集鼻咽拭子,采用多重PCR技术检测常见的7种(11个亚型)呼吸道病毒。同时采用间接免疫荧光法检测多种病毒血清特异性IgM抗体。同期健康体检者106例作为对照组。结果对照组106例仅4例阳性。观察组192例患者鼻咽拭子中80例检出99株病毒,患者阳性率41.6%,病毒检出率51.5%。检出病毒以流感病毒A型(FluA)、鼻病毒(RhV)、副流感病毒1型(PIV1)为主,三者占检出病毒株的81.8%(81/99)。血清学检测发现61例73种(型)病毒阳性,患者阳性率31.7%,病毒阳性率38.0%,以FluA、PIV1和呼吸道合胞病毒(RSV)检出为主。两种标本综合结果 192例患者中共91例110株(型)阳性,患者阳性率47.3%,病毒阳性率57.2%。结论成人下呼吸道感染患者中病毒感染具有较高比例,以FluA、RhV、PIV1为主。

Objective To investigate the viral etiology of acute lower respiratory tract infection in adult inpatients.Methods 192 adult inpatients suffering from community-acquired pneumonia,acute bronchitis,or acute exacerbation of chronic obstructive pulmonary disease,admitted from October 2007 to October 2008,were enrolled in the study.SwAbs from the nasopharynxes were collected.Multiple polymerase chain reaction was employed to identify the 7 common species of respiratory virus （including 11 subspecies）.Serum specific IgM against several viruses were detected by indirect immunofluorescence.106 healthy volunteers were enrolled as control.Results Only 4 cases were found to be infected with virus in 106 healthy volunteers.Viruses were identified in 80 （41.6%） cases of 192 inpatients and 99 （51.5%） viral strains were detected.The most common viruses identified in the inpatients were influenza virus A （FluA）,rhinovirus （RhV）,and parainfluenza virus 1 （PIV1）.The ratio of the 3 virus strains to the all strains identified was 81.8% （81/99）.Serum specific IgM was positive in 61 （31.7%） inpatients and 73 （38.0%） viral strains were detected.The most common viruses identified in the inpatients were FluA,PIV1,and respiratory syncytial virus （RSV）.When summing up the data from the swAbs and serum,91 （47.3%） cases had viral infection in 192 inpatients and 110 （57.2%） viral strains were detected.Conclusion The rate of viral infection is relatively high in the adult inpatients with acute lower respiratory tract infection,and the most common species are FluA,RhV,and PIV1.