儿童急性下呼吸道病毒感染的临床流行特征

Epidemiological features of acute lower respiratory tract viral infections in children

目的了解小儿急性病毒性下呼吸道感染的流行特征。方法回顾性分析2006至2010年住院的急性下呼吸道感染儿童鼻咽吸取物4种7型常见呼吸道病毒的检出情况以及季节和年龄分布特点。直接免疫荧光法检测病毒。结果4355例患儿中有1093例病毒检测阳性，总阳性率25．1％，其中呼吸道合胞病毒（RSV）阳性率17．6％，副流感病毒（PIV）-3为2.7％，腺病毒（ADV）为2．0％，流感病毒（IV）-A1．3％，PIV-1为0-7％，PIV-2为0．3％，IV—B为0．2％，混合感染0．3％。病毒感染患儿年龄中位数RSV为4个月，PIV-3为9个月，ADV为13个月，PIV-1为11个月，IV为13．5个月，差异有统计学意义（X。=46．186，P〈0．01）。RSV感染率在婴幼儿最高，后随着年龄增长而降低，PIV-3在婴幼儿感染率较高，仅次于RSV。RSV通常在冬春季流行。毛细支气管炎、支气管炎、肺炎、哮喘急性发作息儿病毒阳性率分别为64．5％、15．6％、17．6％、3117％。结论病毒依然是小儿下呼吸道感染的主要病原，发病年龄主要在婴幼儿，其中以RSV和PIV-3最常见。毛细支气管炎主要病原仍是RSV。

Objective To investigate the epidemiological features of acute lower respiratory tract viral infections in children. Methods A retrospective epidemiological investigation was conducted to analyze the prevalence rate, seasonality and susceptible population of seven common respiratory viruses among 4355 hospitalized pediatric patients （〈 15 y） with acute res- piratory tract infection during 2006 to 2010. Nasopharyngeal aspirates were screened for virus by direct immunofluorescent （DIF） assay. Results Virus was identified in 1093 out of 4355 patients （25.1%）; RSV accounted for 17.6%, followed by PLY-3 （2.7%）, ADV（2% ）, IV-A（ 1.3% ）, PIV-1（0.7% ）, PIV-2（0.3% ）, IV-B（0.2% ）and mixed（0.3% ）. The median ages of infected pediatric patients were 4 months for RSV, 9 months for PIV-3, 13 months for ADV, 11 months for PIV-1 and 13.5 months for IV, respectively （ χ2= 46.186,P〈0.01 ）.The infants and younger children were more susceptible for developing RSV and PIV-3 related disease, and RSV often occurred in winter and spring. The prevalence of viral infection in children with bronchiolitis, bronchitis, pneumonia and asthma were 64.5%, 15.6%, 17.6% and 31.7%, respectively. Conclusion The respiratory viruses are still a main cause of lower respiratory tract infections in children, especially in infants and younger children. RSV remains the main pathogen of bronchiolitis.