人类博卡病毒与呼吸道合胞病毒 偏肺病毒感染临床特征比较

Comparison of clinical features in the respiratory infection children caused by human bocavirus,respiratory syncytial virus,human metapneumovirus.

目的探讨人类博卡病毒(HBoV)、呼吸道合胞病毒(RSV)、人类偏肺病毒(hMPV)所致儿童急性呼吸道感染临床特征的差异性。方法选取2009年2月至2010年1月苏州大学附属儿童医院呼吸科收治的1885例因急性呼吸道感染住院的患儿,应用无菌负压吸引法采集鼻咽分泌物,采用直接免疫荧光法检测呼吸道合胞病毒(RSV)、腺病毒(ADV)、流感病毒A(InfA)、流感病毒B(InfB)、副流感病毒1(Pinf1)、副流感病毒3(Pinf3)等呼吸道常见的7种病毒;逆转录-聚合酶链反应法(RT-PCR)检测hMPV感染;实时PCR方法检测HBoV感染。重点比较RSV、hMPV、HBoV3组患儿的感染特征。结果 1885例标本中,检测到145份HboV-PCR阳性扩增产物,阳性率为7.69%,其中单纯HBoV感染120例(82.76%),混合其他病毒感染者25例(17.24%)。HBoV检测阳性率在秋季呈现高峰,感染患儿的平均年龄为22.09月龄,较RSV、hMPV感染患儿年龄大。3种病毒引起急性呼吸道感染的临床特征相似,但RSV感染患儿以气促和喘息多见,HBoV感染患儿以发热更多见。结论 HBoV是苏州大学附属儿童医院急性呼吸道感染住院患儿的常见病原之一;HBoV感染的流行病学不同于RSV、hMPV,临床特征也不完全相似。

Objective To compare the clinical features among respiratory tract infections associated with human bocavirus（HBoV）, respiratory syncytial virus（RSV） or human metapneumovirus（hMPV）. Method A total of 1885 nasopha- ryngeal aspirates from hospitalized children were collected during February 2009 to January 2010. We adopted real-time polymerase chain reaction （PCR） for detecting HBoV as well as direct fluorescent assay for detecting RSV, and reverse transcription polymerase chain reaction （RT-PCR） for detecting hMPV. Results Of 1885 patients, 145 （7.69%） patients were identified with HBoV infection. Among them, single HBoV infection was in 120 cases（82.76%）, and 25 of the 145 HBoV -positive children （ 17.24% ） had coinfection with other respiratory virus.HBoV was frequently detected in autumn. The median age of patients with HBoV infection was 22.09 months, which was older than the pa- tients with RSV or hMPV infection.The clinical features were similar among the three viruses, but tachypnea and wheez- ing were more common in the patients with RSV infection while fever was even more common in the patients with HBoV infection. Couculsion HBoV is one of the common viruses that can cause acute respiratory tract infection in children in Sochow area. Clinically, epidemiology of HBoV infection can be discriminated from the infection of RSV or hMPV.