婴幼儿喘息性疾病的病毒病原学研究

Viral etiology study on the wheezing diseases of infants and young children

目的了解婴幼儿喘息性疾病常见呼吸道病毒感染的病原学情况。方法采集318例婴幼儿喘息性疾病住院患儿的鼻咽部分泌物标本，采用逆转录一聚合酶链反应（RT—PCR）进行呼吸道合胞病毒（RSV），流感病毒A、B型（INFA、B），副流感病毒I、Ⅱ、Ⅲ型（PIVI、Ⅱ、Ⅲ），腺病毒（ADV），鼻病毒（RV），偏肺病毒（hMPV）检测。结果318例婴幼儿喘息性疾病中检出呼吸道病毒阳性258例，阳性率为81．1％。检出6种呼吸道病毒，其阳性率分别为RSV36．2％，hMPV21．7％，RV14．5％，INF—B1．3％，PIV-Ⅲ3．1％，ADV5．3％。4至6月份病毒阳性检出率最高（92．7％），1至3月份病毒阳性检出率最低（51．3％）。1岁以前主要是RSV和hMPV感染，1～3岁主要是RSV和RV感染。毛细支气管炎及喘息性支气管炎主要是RSV、hMPV感染，婴幼儿哮喘主要是hMPV、RV感染。结论合胞病毒是婴幼儿喘息性疾病的首位病毒病原体，其次是hMPV、RV．喘息患儿．病毒检出阳件率旱季节件分布．日随年龄增长旱下降档蚺．

Objective To understand the etiology features of common respiratory viral infec- tions of the infant wheezing disease. Methods 318 cases of asthmatic disease of infants and young hospitalized children were collected with their nasopharyngeal secretions specimens by reverse transcrip- tion-polymerase chain reaction （RT-PCR）, respiratory syncytial virus （RSV）, influenza virus A, B（INFA, B） parainfluenza virus I, ]], HI type （PIV ], I], 11I）, adenovirus （ADV）, rhinovirus （RV）, metapneumovirus （hMPV） detected. Results Among 318 cases of infant wheezing disease, 258 cases of respiratory virus- positive were detected, the positive rate of 81.1%. 6 kinds of respiratory viruses detected, the positive rate for RSV 36.2%, hMPV 21.7%, RV 14.5%, INF-B 1.3%, PIV ]I[3.1%, ADV 5.3%. 4-6 month virus positive rate up to 92.7%, January-March had the lowest virus detection rate 51.3%.1 year ago in the asthmatic disease was mainly RSV and hMPV infection, 1-3 years old asthmatic disease was mainly RSV and RV infection. Bronchiolitis and asthma fine bronchitis was mainly RSV, hMPV infection, infantile asthma was mainly hMPV, RV infection.Conclusions Syncytial virus is the first viral pathogens of diseases of the wheezing infants, followed by hMPV, RV. Wheezing in children with virus positive rate shows a seasonal distribution, and decreases with age rising.