C型鼻病毒在儿科重症监护室的检测及其临床意义

Detection of human rhinovirus C in pediatric intensive care unit

目的：探讨儿科重症监护室C型鼻病毒作为病原体的重要性及其临床意义。方法收集2010年11月至2012年4月入住儿科重症监护室呼吸道感染患儿的咽拭子标本570份,应用巢式RT-PCR对标本行鼻病毒 VP2/VP4及5′UTR基因扩增,同时检测常见呼吸道病毒及细菌,并收集及分析相应病例的临床资料。结果570份咽拭子标本中,鼻病毒阳性170份（29．8%）,其中34份（20．0%）未成功分型,分型成功136份（80．6%）,分型成功的标本中单纯鼻病毒阳性85份,包括A型52份,B型7份,C型26份。 C型鼻病毒核苷酸同源性为74．0%-99．2%,核苷酸变异率为3．4%-32．3%。 C型鼻病毒感染高发季节分别为春、冬季及秋末、冬初。咳嗽、发热、喘息、气促在C型鼻病毒感染患儿中多见。结论重症感染患儿中C型鼻病毒有较高的检出率,C型鼻病毒常引起患儿咳嗽、发热、气促和喘息。

Objective To study the significance of human rhinovirus C as a pathogen and the clinical features of human rhinovirus C infection in pediatric intensive care unit. Methods From November 2010 to April 2012,570 nasopharyngeal aspirates specimens were collected from children who were admitted to the pediatric intensive care unit with respiratory infections. Nest reverse transcription-polymerase chain reactions were applied to detect the human rhinovirus C. The other common respiratory viruses were detected by multiplex polymerase chain reaction. The clinical data were collected. Results One hundred and seventy human rhinovirus positive samples （ 29. 8%） were detected in 570 nasopharyngeal aspirates specimens. The VP2/VP4 and 5′UTR region of the human rhinovirus genome was amplified from 170 human rhinovirus positive samples with 80. 6%（136/170） success. While 20. 0%（34/170） samples in total were unclassified to species. There were 85 single infected samples including 52 of type A,7 of type B,26 of type C. The nucleotide homology was 74. 0% to 99. 2% and the nucleotide variations was 3. 4% to 32. 3% in stains of human rhinovirus C. The late fall and early winter were the epidemic seasons of human rhinovirus C infection. Cough,fever, polypnea and wheezing were the common symptoms. Conclusion Human rhinovirus C is the major cause of infectious disease in pediatric critical illnesses. Human rhinovirus C infections often cause cough, fever,polypnea and wheezing.