天津市儿童急性上呼吸道感染病毒病原学分析

Viral etiology in children with an acute upper respiratory infection in Tianjin

目的了解天津地区儿童急性上呼吸道感染中病毒分布情况,探讨不同病毒的流行趋势,为临床诊断与治疗提供病原学依据,同时为今后制定正确的预防策略奠定基础。方法采用多重RT-PCR法,对249份咽拭子标本同时检测腺病毒,人偏肺病毒,人冠状病毒229E/NL63,1型、2型、3型副流感病毒,甲型、乙型流感病毒,甲型、乙型呼吸道合胞病毒,A/B型人鼻病毒,人冠状病毒OC43/HKU1共12种常见呼吸道病毒。结果 249份标本中共检出阳性标本144份,阳性率为57.83%,2种以上病毒混合感染为7份,占2.81%;在阳性检测结果中流感病毒占53.64%,腺病毒占21.19%,呼吸道合胞病毒占8.61%;流感病毒中H3N2亚型占49.38%,甲型H1N1亚型占34.57%,B型占16.05%。结论流感病毒、腺病毒和呼吸道合胞病毒为天津地区儿童急性上呼吸道病毒感染的主要病原体,不同的病毒在时间上有一定的流行规律。

Objectives To determine the viral etiology in children with an acute upper respiratory infection in Tianjin and to discuss the epidemiology of different respiratory viruses so as to provide etiological data for clinical diagnosis and treatment and to provide a basis for formulation of proper preventive strategies. Methods Multiplex RT-PCR detected 12 types of common respiratory viruses, including adenovirus, human metapneumovirus, human coronavirus 229E/ NL63, parainfluenza virus 1, 2, and 3, influenza virus A and B, respiratory syncytial virus A and B, human rhinovirus A/B, and human coronavirus OC43/HKU1, present at the same time in 249 clinical swabs. Results Of the 249 speci- mens, 144 were positive for a positive rate of 57.83 %. Seven specimens, accounting for 2.81%, had co-infections caused by 2 or more types of viruses. Of the positive specimens, 53.64% had the influenza virus, 21.19% had adenovirus, and 8.61% had respiratory syncytial virus. Influenza A subtypes H3N2 and HIN1 were detected at a rate of 49.38% and 34.57% and influenza type B was detected at a rate of 16.05%. Conclusion The influenza virus, adenovirus, and re- spiratory syncytial virus were the main pathogens leading to an acute upper respiratory infection in children in Tianjin, and different pathogens caused regular outbreaks at certain times.