2006-2012年杭州地区儿童下呼吸道腺病毒感染流行情况调查分析

Epidemiological study on adenovirus infection in children with acute low respiratory tract infection in Hangzhou city

目的了解杭州地区儿童下呼吸道腺病毒（ADV）感染流行情况。方法因急性下呼吸道感染（ ALRTI）住院的患儿共76518例，所有ALRTI患儿的鼻咽分泌物均采用直接免疫荧光法作腺病毒等7种病毒的病原学测定。结果76518例标本中ADV阳性479例，阳性率0.63%；男∶女为2.24∶1；年龄中位数16个月（1～172个月），年龄＜6个月39例（8.14%），～24个月265例（55.32%），～36个月66例（13.78%），～60个月72例（15.03%），＞60个月37例（7.72%）。春季176例（36.74%），夏季124例（25.89%），秋季51例（10.65%），冬季128例（26.72%），冬、春、夏季发病率明显高于秋季，差异均有统计学意义（P＜0.05或0.01）。冬、春、夏季节之间比较，差异无统计学意义。从2007-2012年春季ADV阳性患儿占同期所有ALRTI患儿的构成比分别为18.01‰，5.73‰，11.85‰，6.35‰，11.77‰，2.66‰，存在每2年1次的流行趋势。结论杭州地区儿童下呼吸道ADV感染全年散发，以冬、春、夏季为主，可能存在每2年1次的春季小流行。6～24个月为感染高峰年龄。

Objective To study the epidemiological characteristics on adenovirus（ADV） infection in children with acute low respiratory tract infection （ALRTI） in Hangzhou city. Methods Nasopharyngeal secretion （NPS） samples were collected from 76,518 hospitalized patients with ALRTI at Children＇s Hospital of Zhejiang University School of Medicine from July 2006 to June 2012. The antigen expressions of 7 viruses including ADV in NPS samples were detected by direct immunofluorescence assays （DFA）. Results Total 479 samples showed positive for ADV accounting for 0.63%（479/76 518）of al samples. The median age of patients was 16 months（1~172 months） and the male/female ratio was 2.24：1. The case distribution in each age group was as fol-lows：39 （8.14%）〈6months, 265 （55.32%）~24 months, 66 （13.78%）~36months, 72 （15.03%）~60months and 37 （7.72%）≥60 months. The season distribution showed that 176 cases in spring （36.74%）, 124 in summer （25.89%）, 51 in autumn （10.65%） and 128 in winter（26.72%）. The morbidity in autumn was significantly lower than that in other three seasons（P〈0.05 or 0.01）;however, there was no significant difference among spring, summer and winter seasons. The patients with ADV infection in ALRTI cases accounted for 18.01‰, 5.73‰, 11.85‰, 6.35‰ and 2.66‰in spring from 2007 to 2011, indicating a biennial epidemic tendency. Conclusion ADV infection is relatively common in Hangzhou city, demonstrating a gender, age and season variation s in children with ALRTI.