广东省2009-2012年呼吸道合胞病毒的流行病学特征

Respiratory Syncytial Virus Epidemiology Character from 2009 to 2012 in Guangdong Province

【目的】对急性呼吸道感染症状病人中呼吸道合胞病毒(RSV)流行情况进行监测,分析RSV在广东地区的流行特征,为今后广东地区RSV的监控和防治提供参考资料。【方法】2009年7月至2012年6月期间在广东省25家哨点医院采集急性呼吸道感染病例咽拭子标本,提取标本RNA,反转录成cDNA,利用巢式PCR进行RSV检测;对RSV阳性标本进行其他6种呼吸道病毒的检测,了解混合感染情况。检测结果采用SPSS 13.0统计软件进行分析,用Excel作图表,对病人人口学特征、不同病例类型、不同性别、不同年龄组和时间的检出情况进行统计描述,率的比较用卡方检验,α取0.05。【结果】共收集了14 227份咽拭子标本,7 318份来自门诊病例,6 909份来自住院病例;男性8 485人,女性5 742人;病人年龄从0岁到110岁。RSV阳性标本1 113份,检出率为7.82%。住院病例检出率明显高于门诊病人检出率(P<0.001),男性病例检出率明显高于女性病例(P<0.001),儿童检出率高于成人(P<0.001),阳性病例中2岁以下儿童所占比例为77.72%;1-4月份RSV检出率较高(P<0.001)。245例发生了混合感染,215例为双重感染,29例为三重感染,1例为四重感染。混合感染中男性病例较多,占69.39%(170/245);住院病例比例较大,占74.70%(183/245);小于3岁的儿童和20～35岁青年人较多,分别为75.51%(185/245)、11.43%(28/245)。混合感染多发生在1～4月。【结论】广东地区RSV的主要感染人群是2岁以下儿童,要加强对0～2岁儿童的防护,特别是男性病例和住院病例;预防工作要全年进行,重点在1～4月,预防因RSV感染导致的住院率和混合感染率增高。

[ Objective ] Surveillance the RSV epidemic condition of patients with acute respiratory infection in Guangdong Province. To analyze the epidemic character of RSV and provide reference material for monitor and prevention for RSV of Guangdong Province. [ Methods ] Collect the swabs of patients with acute respiratory infection from 25 hospitals in Guangdong Province from July 2009 to June 2012. To extract the samples RNAs and transcribe to cDNA. Detect RSV with nest-PCR. For the RSV positive samples,another six respiratory viruses were also detected to analyze the co-infection conditions. The results were analyzed by SPSS 13.0 statistic software. The charts were drawn by Excel. The demographic characteristics and detection results for different case type, sex, age and time were described. The comparison of rates were analyzed with chi-square test.α=0.05. [Results] There were total 14227 swabs collected, among of them 7318 from outpatients and 6909 from inpatients; 8485 were males and 5742 were females. The age was from 0 to 110 years old. 1113 samples were RSV positive. The detection rate was 7.82%. The detection rate of inpatients was higher than that of outpatients （P 〈 0.001 ）, and males higher than females （P 〈 0.001 ） ; children higher than adults （P 〈 0.001 ）. Kids under 2 years old accounted for 77.72% of the positive samples. The detection rate of RSV was higher during January to April than other months （P 〈 0.001 ）. There were 245 RSV positive samples co-infected with at least one another respiratory virus. A total of 215 were double-infection; 29 were tri-coinfection and one was quart-co-infection. Among the co-infection cases, males and inpatients accounted for most, 69.39% （170/245） and 74.70% （183/245） respectively. The number of the children under 3 years old and young from 20-35 years old were more than other age groups, accounting for 75.51% （185/245） and 11.43% （28/245）. The co-infection was most likely detected from January to April. [Conclusions] Children under 2 years old were the most RSV infected group and needed for more protections, especially for males and inpatients. Prevention were needed through the year, pay more attention to from January to April. Prevent the increase of hospitalization rate and co-infection rate caused by RSV.