甘肃省2010-2013年942例下呼吸道感染病例病毒病原特征分析

Study on viral etiology of 942 cases of lower respiratory tract infections in Gansu Province during 2010-2013

目的了解甘肃省下呼吸道感染常见病毒病原及临床表现。方法收集传染病监测信息系统中2010-2013年省内10所哨点医院942例下呼吸道感染病例信息,采集鼻咽拭子/抽吸物、痰、肺泡灌洗液等呼吸道标本及血液、血清、胸腔穿刺液,采用聚合酶链反应法对流感病毒(influenza,Flu)、呼吸道合胞病毒(respiratory syncytial virus,RSV)、腺病毒(adenovirus,Adv)、副流感病毒(parainfluenza virus,PIV)、偏肺病毒(human metapneumovirus,h MPV)和人冠状病毒(human coronavirus,HCo V)进行核酸检测,采用描述性统计学方法分析病例信息、临床表现和病原检测结果。结果 942例病例男女数之比为1.93∶1,年龄中位数为47.73岁,病原检出率为31.32%,多重感染为3.08%,病原检出顺位为Flu(13.63%)、RSV(8.69%)、PIV(4.87%)、HCo V(4.14%)、Adv(2.38%)和h MPV(2.09%),<2岁儿童(217例)中RSV(20.00%)、PIV(10.89%)和Flu(9.43%)居前3位,≥15岁人群(508例)中Flu(15.35%)、HCo V(7.09%)和RSV(5.71%)居前3位。病例主要临床表现为咳嗽(89.81%)、咳痰(64.65%)和发热(58.39%),腹痛、腹泻仅为1.27%、6.26%。结论甘肃省下呼吸道感染病例病毒以Flu、RSV和PIV为主,儿童和成人感染的主要病毒及临床表现均不相同。

Objective To explore the common viruses and clinical features of lower respiratory tract infections （LRTIs）in Gansu Province. Methods Through ＂infectious diseases monitoring technology platform information management system＂, 942 cases of LRTIs during 2010 -2013 were collected from l0 sentinel hospitals in Gansu Province. Nasopharyngeal swabs, nasopharyngeal aspirates, sputum, bronchoalveolar lavage fluid, blood, serum and pleural puncture fluid were detected by polymerase chain reaction （ PCR ） for influenza （ Flu ）, respiratory syncytial virus （ RSV ）, adenovirus （ PIV ） , human coronavirus （HCoV） , adenovirus （Adv） and human metapneumovirus （hMPV）. All of the information were analyzed by descriptive statistical methods. Results The sex ratio was 1.93 ： 1 and the median age was 47. 73. The detection rate of virus was 31.32% and the co-infections rate was 3.08%. The positive rates of Flu, RSV, PIV, HCoV, Adv and hMPV were 13.63%, 8. 69%, 4. 87%, 4. 14%, 2. 38% and 2.09%, respectively. RSV（20.00%）, PIV .（ 10. 89% ）and Flu （9.43 % ） were the main viruses in the group of 〈 2 years old. Flu （ 15. 35 % ）, H CoV （7.09%） and RSV（5.71% ） were the major viruses in the group of ≥ 15 years old. The major clinical syndrome included cough （89. 81% ）, expectoration （64. 65% ） and fever （58. 39% ）. Abdominal pain and diarrhea were 1.27% and 6. 26%. Conclusions The main viruses of LRIs in Gansu Province are Flu, RSV and PIV. The main viruses and manifestations of children and adults differ obviously.