急性喘息患儿人博卡病毒检出及病毒载量与疾病严重程度相关分析

Detection of human bocavirus in children with acute wheezing and the relevant analysis about its viral load

目的了解博卡病毒(HBOV)在急性喘息患儿中的流行病学特点及病毒载量与相应疾病严重程度的关系。方法收集2011年3月至2011年8月温州育英儿童医院住院部237例急性喘息患儿和同期96例无喘息住院患儿鼻咽部分泌物标本。采用荧光定量多聚酶链反应方法进行HBOV检测。结果 237例急性喘息患儿鼻咽部吸取物中共检出HBOV阳性62例(26.2%),96例无喘息患儿鼻咽部吸取物中,共检出HBOV12例(12.5%),两组HBOV检出率差异有统计学意义(χ2=7.377,P<0.01)。62例HBOV阳性患儿中,28例(45.16%)混合其他病毒感染,其中合并RSV感染21例(33.87%)。RSV单一感染与HBOV单一感染患儿、HBOV单一感染与HBOV混合感染患儿临床资料两两比较,差异无统计学意义(P>0.05)。HBOV阳性患儿的鼻咽部吸取物中病毒载量介于2.59×103～5.36×109拷贝/mL,中位数为6.2×103拷贝/mL(四分位数间距,2.6×103～4.4×104拷贝/mL);HBOV单一感染组患儿疾病严重程度与病毒载量的等级呈显著正相关,相关系数r=0.752(P<0.01);HBOV混合感染组患儿疾病严重程度评分与病毒载量的等级无相关性(P>0.05)。结论 HBOV在急性喘息患儿中流行,是导致婴幼儿喘息的重要病原。HBOV单一感染时其致病作用随着病毒载量等级的升高而增强。

Objective To investigate the epidemiologic features of human bocavirus （HBOV） in children with acute wheezing in Wenzhou area and analyze the correlation between disease severity and viral load. Method Between March and August of 2011,237 nasopharyngeal aspirates （NPA）were collected from children who had been hospitalized for acute expiratory wheezing in Wenzhon Yuying children＇s hospital. During the same period, 96 control specimens were obtained from children hospitalized without wheezing. HBOV was assessed in all samples by real-time PCR method. Re- suits HBOV was detected in 62 （26.2%）NPA samples from 237 acute wheezing children and in 12 （12.5%）NPA sam- ples from control children without wheezing, there being a statistically significant difference in the detection rates of HBOV between the symptomatic group and the asymptomatic group（X^2=7.377, P 〈 0.01 ）. Of 62 HBOV positive cases , 28 patients （45.16%） mixed other viruses, in which 21 cases （33.87%） combined RSV infection. To compare the clini- cal characteristics between RSV single infection and HBOV single infection , there was no statistical significance （P 〉 O.05）.No statistical significance was found beween HBOV single infection and HBOV mixed infection （P 〉 0.05）. HBOV viral load in HBOV-positive patients varied very broadly, from2.59 ×10^3to5.36 ×10^9 copies/mL, the median vi- ral load was 6.2×10^3 copies/mL（interquartile range, IQR 2.6×10^3 - 4.4×10^4 copies/mL）. A positive correlation between disease severity and the rank of viral load was found in cases with HBOV single infection （r = 0.752, P 〈 0.01 ）, there be- ing no correlation between disease severity and the rank of viral load found in cases with HBOV mixed infection（P 〉 0.05）.Conclusion Human bocavirus is prevalent in children with acute wheezing in Wenzhou area and is one of the major respiratory pathogens causing infants wheezing. The pathogenic role in HBOV single infection improve with therise of viral load level.