0～2岁婴幼儿呼吸道病毒监测及临床特征分析

Surveillance of viral etiology of acute lower respiratory tract infection in 0-2 years old infant

目的 了解绍兴市妇幼保健院0～2岁婴幼儿急性呼吸道感染病毒病原学构成及临床特征,为临床诊疗提供参考。方法 2011年10月—2013年9月绍兴市妇幼保健院住院的呼吸道感染患儿共3677例。采集每例患儿鼻咽吸取物1份,用荧光免疫方法进行病毒检测,包括呼吸道合胞病毒、流感病毒A和流感病毒B、副流感病毒1、2、3、腺病毒。结果 总的病毒阳性检出率25.40%。检出率较高的前3位病毒分别为呼吸道合胞病毒55.03%（514/934）,其流行月份在1～2月和11～12月;副流感病毒3,占17.24%（161/934）,其流行月份在5～8月;流感病毒A,占10.06%（94/934）,其流行月份在3～5月。0～3月患儿主要感染呼吸道合胞病毒（22.84%）,1～2岁患儿流感病毒A感染（3.82%）及腺病毒感染（3.73%）也较常见。呼吸道合胞病毒主要引起肺炎及毛细支气管炎,临床表现以咳嗽、气喘为主;流感病毒A、腺病毒主要引起上呼吸道感染,临床表现以发热为主。结论 病毒是0～2岁婴幼儿急性呼吸道感染的主要病原,以呼吸道合胞病毒、副流感病毒3较为多见,其感染存在季节性特征,临床特征有差异,在临床诊疗时应加以注意。

Objective To investigate the viral pathogens of respiratory infections in 0- 2 years old infants of and clinical features of different viruses,and to conduce clinical diagnosis. Methods Totally infant diagnoses of respiratory infections during the period of 2011. 10 to 2013. 9 were recruited into this study. These patients were hospitalized patients in department of internal medicine. One Nasopharyngeal aspirates specimen was collected from each patient. Fluor immunifaction methods were applied to detect common respiratory viruses including respiratory syncytial virus（ RSV）,influenza virus type A,B,parainfluenza virus（ PIV） type 1- 3,adenovirus（ ADV）. Results The total positive rate of viruses was 25. 40%. The top virus was RSV（ 55. 03%）,the epidemic months of RSV were January-February and September-December,the second one was PIV-3（ 17. 24%） whose epidemic months were from May-August and the IV-A（ 10. 06%） were from March-May. The top virus in groups of 0-3 months＇ infants was RSV（ 22. 84%）,and in groups of 1- 2 years＇ infant was IV-A（ 3. 82%） and the adenovirus infection was（ 3. 73%）. RSV can cause pneumonia and bronchiolitis whose clinical manifestations were cough and asthma. Influenza virus type A and adenovirus can cause upper respiratory infections whose clinical manifestation was high fever. Conclusion Virus was the main athogens in 0- 2 years＇ infants with respiratory infections. Different viral infections had different seasonal features,which can conduce to clinical diagnosis.