四川省崇州市儿童急性病毒性扁桃体炎流行病学特征分析

Andlysis on epidemiological characteristics of children with acute viral tonsillitis in Chongzhou city

目的了解四川省崇州市儿童急性病毒性扁桃体炎的流行病学特征。方法采集2013年1—12月在我院儿科住院的220例急性扁桃体炎患儿的血清，应用间接免疫荧光法（IFA）检测血清中的乙型流感病毒（IBV）、副流感病毒（PIV）、甲型流感病毒（IAV）、腺病毒（ADV）、呼吸道合胞病毒（RSV）的特异性IgM抗体。结果①220例患儿中，病毒特异性IgM阳性117例，总阳性率为53．18％，其中IBV IgM阳性52例，PIV IgM阳性17例，IAVIgM阳性12例，ADVIgM阳性10例，RSVIgM阳性0例。混合感染以IBV＋PIV、IBV＋IAV、IBV＋ADV为主。②≤1岁、～3岁和〉3岁3个年龄组总感染率依次为33．3％、61．39％和50％。在≤1岁组中，PIV、IBV、ADV阳性率为18．52％、7．41％和7．41％；～3岁组IBV、PIV、IAV阳性率为29．70％、7．92％和4．95％；〉3岁组IBV、IAV、PIV、ADV阳性率为21．74％、7．61％、4．35％和4．35％。各年龄组间总的感染例数比较，差异有统计学意义（X2=7．377，P=0．025）；总感染例数两两比较，≤1岁与～3岁组差异有统计学意义（X2=6．788，P=0．009）。③春夏秋冬四季病毒的阳性率依次为77％、43％、47％和53％。各季节组间总的感染率比较，差异无统计学意义（X2=7．147，P=0．067）。结论2013年崇州市儿童急性扁桃体炎病毒感染率高，以常见的流感病毒和腺病毒感染为主。发病的高发年龄是1岁以上的儿童。病毒感染无明显的季节性。

Objective To understand the epidemiologieal characteristics of children with acute viral tonsillitis in Chongzhou city. Methods Serum specimens of 220 children with acute tonsillitis who were hospitalized in our pediatric department from January to December 2013 were collected. Serum specific IgM antibodies against influenza B virus（ IBV）, paminfluenza（PIV） ,influenza A virus （IAV）, adenovims（ ADV ）and respiratory syncytial virus （RSV）were detected by using an indirect immunofluoreseenee assay（ IF A ）. Results ①of 220 cases,117 children had specific IgM antibodies against virus（ total positive rate was 53. 18% ）. There were 52 chil- dren with IBV IgM antibedy,17 with PIV IgM,12 with IAV IgM,10 with AVD lgM and 0 with RSV lgM. Main mixed infections were IBV with PIV,IBV with IAV and IBV with ADV. ②The total positive rates of specific IgM antibodies in three age group was 33.3%, 61.39% and 50% ,respectively. In the≤1 year group,the positive rates were 18. 52% for PIV,7. 41% for IBV,and 7.41% for ADV. In the - 3 years group, the positive rates were 29. 70% for IBV,9. 72% for PIV and 4. 95 % for IAV. In the 〉3 years group, the positive rates were 21.74% for IBV,7. 61% for IAV,4. 35% for PIV and 4. 35% for ADV. The total difference of infection cases among the three age groups were statistically signifieant（X2 = 7. 377 ,P = 0. 025 ）. The difference between the ≤ 1 year group and the - 3 years group was statistically significant（X2 =6. 788,P =0. 009）under pair wise comparison. ③The positive rates of viral specific IgM antibod- ies among four seasons were 77% ,43% ,47% and 53% ,respectively. The difference of total infection rates among four seasons were not statistically signifieant（X2 = 7. 147 ,P = 0. 067 ）. Conclusion The virus infection rate in children with acute tonsillitis was high in Chongzhou city during 2013. The infected varies were mainly influenza virus and adenovirus. Virus infection is related to age in which children over 1 year old are most susceptible. However, virus infection is not significantly seasonal.