粤东地区2008-2010年急性呼吸道感染住院儿童中人鼻病毒检出及临床分析

Detection and clinical features of human rhinovirus in hospitalized children with acute respiratory tract infection in eastern areas of Guangdong province

目的了解2008--2010年粤东地区急性呼吸道感染住院儿童人鼻病毒（HRV）的检出情况、流行规律和感染特点。方法应用PCR和RT-PCR技术对2008年10月至2010年9月汕头大学第二附属医院儿科住院的部分急性呼吸道感染患儿咽拭子，进行HRV、呼吸道合胞病毒（RSV）等常见10种呼吸道病毒核酸检测，并收集HRV和RSV阳性患者资料。结果1335例呼吸道感染住院患儿咽拭子阳性率最高的是流感病毒A型（IVA）（25．1％），其次是RSV（15．1％），HRV（9．3％）。HRV感染几乎常年都有发生，2009年检出高峰在夏季，2010年为秋季。单纯HRV感染和混合其他病毒感染的患儿临床症状、体征、胸片、白细胞计数、急性反应蛋白和住院天数的差异无统计学意义。单纯HRV和单纯RSV感染患儿临床症状与体征相似，喘息和咳嗽在RSV感染的患儿中更为多见，单纯RSV感染患儿诊断为毛细支气管炎（25例，28．4％）高于单纯HRV感染（6例，10．7％），差异有统计学意义（r=0．281，P=0．596）。结论HRV是粤东地区急性呼吸道感染较为常见的病原，流行季节随年份的不同略有差异，婴幼儿普遍易感。HRV感染患儿所致毛细支气管炎、咳嗽和喘息均较RSV少，但HRV和哮喘急性发作密切相关。

Objective To investigate the prevalence and clinical features of human rhinovirus （HRV） infection in hospitalized children with acute respiratory （ARI） in eastern areas of Guangdong province from 2008 to 2010. Methods From Oct. 2008 through Sep. 2010, nasopharyngeal aspirates were collected prospectively, from hospitalized children with acute lower respiratory tract infection at the Second Hospital, affiliated to the Shantou University Medical College. Multiplex PCR was applied to detect ten kinds of viruses including HRV, RSV in the hospitalized children with respiratory tract infection. Clinical data on HRV-positive cases or RSV-positive cases were collected and analyzed. Results Among all the 1335 specimens, 124 were confirmed as HRV-positive cases （9.3%）, with IVA-positive rate as the highest （25.1%） , followed by RSV-positive rate （15.1%）. HRV infection occurred sporadically around the year, with the highest HRV-positive rate seen in spring 2009 and autumn in 2010. Symptoms, signs, chest X-ray, leukocyte count and CRP count did not differ between patients with co-infection or single HRV infection. Clinical symptoms or signs were similar between those with single HRV infection or single RSV infection in children, but the single RSV infected children were more frequently seen with wheeze and cough. 28.4% of the single RSV infected children had bronchiolitis while 10.7% of single HRV infected children were seen （x2=0.281, P=0.596）.Conclusion HRV was a relatively common cause for acute respiratory infections in the eastern areas of Guangdong province. The highest HRV-positive rate was slightly different in different years. Infants and young children were generally susceptible to rhinovirus infection. Bronchiolitis, wheeze and cough associated with HRV infection happened less than those caused by RSV.