长沙地区儿童急性呼吸道感染病毒病原学分析

Pathogenic Analysis of Acute Respiratory Infections Among Children in Changsha Area

目的了解长沙地区儿童急性呼吸道感染(acute respiratory infection,ARI)患儿病毒病原感染流行情况,为临床诊断ARI患儿提供病毒病原学依据。方法 2011年6月-2012年6月,取2 209例住院ARI患儿的鼻咽深部分泌物用直接荧光免疫快速检测和鉴定七种常见的呼吸道病毒,主要包括呼吸道合胞病毒(RSV)、腺病毒(ADV)、甲型和乙型流感病毒(IVA和IVB)、副流感病毒1、2和3型(PIV-1、2、3)。结果 2 209例标本中病毒总检出例数为1 497例(67.8%),其中RSV检出率最高53.96%(1 192/2 209),没有检测出副流感Ⅱ型病毒。流感病毒A在男女性别中检出阳性率差异有统计学意义(χ2=5.749,P<0.05),女性高于男性,其它ARI病原体在男女性别中检出阳性率差异无统计学意义(P>0.05)。呼吸道合胞病毒、腺病毒在各年龄组中婴儿组和幼儿组检出率高于其它年龄组,差异有统计学意义(χ2=12.65、17.77,P<0.05),其它ARI病原体在各年龄组检出阳性率差异无统计学意义(P>0.05)。ARI病原体中副流感Ⅰ型、Ⅲ型病毒、呼吸道合胞病毒和腺病毒不同季节检出率差异有统计学意义(P<0.01),其它ARI病原体在4个季节的检出阳性率差异无统计学意义(P>0.05)。结论病毒的检出率与年龄、性别、季节有关系,呼吸道合胞病毒、副流感Ⅲ型病毒和腺病毒是长沙地区儿童急性呼吸道感染的主要病原。

Objective To investigate the prevalence of common respiroviruses of acute respiratory infections（AIR） among children in Changsha area,and to provide evidence of viral etiology for clinical diagnosing AIR in children.Methods A total of 2,209 hospitalized children with ARI from June 2011 to June 2012 were enrolled in this study.Secretion specimens were obtained from deep part of nasopharynx and detected by rapidly direct fluorescence immunoassay for seven respiroviruses,including respiratory syncytial virus（RSV）,adenovirus（ADV）,influenza A and B virus（IVA and IVB）,parainfluenza viruses types 1,2,and 3（PIV-1,PIV-2,and PIV-3）.Results One or more viral strains were detected in 1,497 of total 2,209（67.8%） specimens.RSV was detected with the most frequency in seven respiroviruses（1,192/2,209,53.96%）,but PIV-2 was not detected.The positive rate of IVA was higher among the female than the male,and the difference was statistically significant（χ^2=5.749,P〈0.05）.No statistically significant difference was found in the positive rates of other respiroviruses between genders（P〈0.05）.The positive rates of RSV and ADV were higher in infant group and children group than in other age groups and the difference was statistically significant（χ^2=12.65,χ2= 17.77,P〈0.05）,but no statistically significant difference was found in the positive rates of other respiroviruses among different age groups（P〈0.05）.There were statistically significant differences in the positive rates of PIV-1,PIV-3,RSV and ADV among different seasons（P〈0.01）,but no statistically significant difference was observed in the positive rates of other respiroviruses among different seasons（P〈0.05）.Conclusions The positive rates of respiroviruses of ARI are related to age,sex and season.RSV,PIV-3 and ADV are major types of viruses in Changsha area.