5岁以下儿童喘息性疾病与呼吸道合胞病毒、偏肺病毒、博卡病毒的相关临床分析

Association of respiratory syncytial virus,human metapneumovirus and human bocavirus infection with wheezing diseases in children under 5 years old

目的分析5岁以下喘息性疾病患儿与呼吸道合胞病毒（RSV）、人类偏肺病毒（hMPV）、人类博卡病毒（hBoV）感染的相关性。方法回顾性分析2010年1月至2013年1月因喘息住院且咽拭子病毒PCR检测阳性的5岁以下儿童共627例的病毒检测结果及临床资料。结果检测出RSV、hMPV、hBoV阳性者共286例，其中RSV173例（27．59％），hMPV70例（11．16％），hBoV43例（6．86％）。5岁以下喘息性疾病患）LRSV感染主要集中在冬春季节，hMPV主要在春季流行，hBoV主要在夏季流行。不同年龄段组、临床诊断组以及喘息严重程度之间病毒检出分布的差异均有统计学意义（P〈0．001）。RSV在〈6个月、毛细支气管炎以及中度喘息的患儿中检出率最高；hMPV多见于1-3岁、喘息性支气管肺炎及轻中度喘息的患儿；而hBoV的检出率与年龄、疾病临床诊断和喘息严重程度无明显关联。结论RSV是诱发婴儿早期喘息及毛细支气管炎的最常见病毒，而hMPV和hBoV也是诱发儿童喘息的重要病毒。

Objective To analyze the association of respiratory syncytial virus （RSV）, human metapneumovirus （hMPV） and human bocavirus （hBoV） infection with wheezing diseases in children under 5 years old. Methods The virus detection re- sults and clinical data of 627 children under 5 years old due to wheezing from January 2010 to January 2013 were retrospective- ly analyzed whose initial throat swab PCR assay was positive for virus. Results Of 286 specimens, 173 （27.59%） were positive for RSV, 70 （11.16%） and 43 （6.86%） were positive for hMPV and hBoV, respectively. Our data showed RSV was prevalent mainly during spring and winter, while hMPV and hBoV mainly in spring and in summer, respectively. The virus distribution was significantly different by age, clinical diagnosis and wheezing severity, respectively （P〈0.001）. The positive rate of RSV was highest in children less than 6 months old, with bronchiolitis or moderate wheezing. Infection of hMPV was common in children aged 1-3 years old, with asthematoid bronchopneumonia or mild-to-moderate wheezing. The detection rate of hBoV had no relationship with age, clinical diagnosis and wheezing severity. Conclusions RSV is the most common virus which in- duces early infant wheezing and capillary bronchitis, hMPV and hBoV are common viruses for inducing childhood wheezing.