儿童社区获得性肺炎病毒病原学及临床流行病学分析

Viral etiology and epidemiological characteristics of 273 children with community- acquired pneumonia

目的了解本地区儿童社区获得性肺炎（CAP）感染病毒病原学构成及其临床流行病学特征。方法对临床确诊为CAP住院患儿273例，采集患儿血清，用酶联免疫吸附测定法进行病毒IgM检测，包括呼吸道合胞病毒（RSV），腺病毒（ADV），流感病毒（IFV）A、B型，副流感病毒（PIV）Ⅰ-Ⅲ型，人偏肺病毒（hMPV）。结果273例患儿中有92例病毒检测阳性，总阳性率33．70％，检出率高的前3种病毒依次为RSV、hMPV和PIV。呼吸道病毒阳性检出率以3个月～2岁组为最高，主集中于冬春季节。毛细支气管炎病毒阳性检出率高达61．22％，RSV为其常见感染病毒（51．09％）。结论银川地区儿童CAP病毒感染主集中于冬春季节，多见2岁以下小儿，其中RSV和hMPV两种病毒最为常见，毛细支气管炎的主病原仍然是RSV。

Objective To understand the viral etiology and epidemiological characteristics of community - acquired pneumonia （CAP） in Yinehuan. Methods 273 children under the diagnosis of CAP hospitalized. 2011 were enrolled. The serum were collected and virus IgM, including respiratory syncytial virus （RSV）, gland virus （ADV）, influenza virus （IFV） A and B, parainfluenza virus （PIV） Ⅰ to 19, human metapneumovirus （ hMPV）, were detected by enzyme - linked immunosorbent assay. Results Out of all the 273 cases, positive results was found in 92 eases, and the positive rate was 33.70 %. The most frequently detected viruses were RSV, hMPV and PIV in order. Children aged 3 months to 2 years old had the highest positive rate of respiratory virus, whose infection mainly occurred in winter and spring. The positive rate was as high as 61.22% in children with bronehiolitis and RSV was the most common virus （51.09%）. Conclusion Virus infection of CAP mainly occurs in winter and spring in Yinchuan area and is more common in children under 2 years old. RSV and hMPV are the most common viruses and RSV is still the main pathogen of bronchiolitis.