西安市毛细支气管炎病原学特点及流行趋势

Etiology characteristics of bronchiolitis in Xi＇ an and its trend analysis

目的了解毛细支气管炎的病毒病原学构成及其临床特点。方法选取2011年9至12月在西安市儿童医院呼吸一科住院中符合毛细支气管炎诊断标准的患儿共120例。采集每例患儿鼻咽分泌物1份，用逆转录反应（RT）PCR方法进行病毒核酸检测，包括呼吸道合胞病毒（RSV）、人鼻病毒（rmv）、副流感病毒（piv）、流感病毒（IFA、IFB、TFc）、腺病毒（ADV）、偏肺病毒（HMPV）及博卡病毒（HBOV），并对结果进行分析。结果①毛细支气管炎呼吸道合胞病毒感染的检出为84例（占70．00％）；②呼吸道合胞病毒为毛细支气管炎最常见的病毒病原；③人类偏肺病毒有可能引起严重的临床症状，检出率为3．33％；④毛细支气管炎的好发季节为每年的11月到次年的3—4月份；@2009至2011年毛细支气管炎发病率比较差异有统计学意义（y。=316．65，P=0．000〈0．05）。结论冬春季节是毛细支气管炎好发季节，以合胞病毒感染为主，人类偏肺病毒感染可致较凶险的IJ盏床症状，需要引起关注。

Objective To understand the virus etiology and clinical characteristics of bronchiolitis. Methods Totally 120 infected children diagnosed with bronchiolitis in Xi＇ an Children＇ s Hospital from September to December in 2011 were selected in study. Nasopharyngeal secretion of each case was collected. RT-PCR was applied to detect viral nucleic acid, including respiratory syncytial virus （RSV）, human rhinovirus （HRV）, parainfluenza virus （PIV）, influenza virus （IFA, IFB and IFC）, adenovirus （ADV）, human metapneumovirus （hMPV） and human boeavirus （HBOV）. The detection results were analyzed. Results RSV was detected in 84 cases （70.00%）, and it was the most common virus in bronchiolitis. HMPV may cause severe clinical symptoms, and the detection rate was 3.33%. Bronchiolitis was likely to occur in the period of November to next March or April in every year. The difference in incidence of bronchiolitis in 3 years was significant （X2 = 316.65, P = 0. 000 〈 0. 05 ）. Conclusion Winter and spring are the frequently-occurring seasons, and RSV is the most common pathogeny of bronchiolitis. HMPV infection may cause dangerous clinical symptoms, which needs to be concerned.