585例儿童急性下呼吸道感染病毒病原学特征分析

Analysis of the characteristics of viral etiology in 585 cases of children with an acute lower respiratory tract infection

目的分析儿童急性下呼吸道感染病毒病原学特征,为儿童急性呼吸道感染的诊疗和控制提供依据。方法以2014年8月-2015年7月广西科技大学第二附属医院就诊的585例儿童急性下呼吸道感染患儿作为研究对象,采集其鼻咽分泌物标本进行14种临床常见呼吸道病毒的病原学检测。结果 585份检测标本中,检测出呼吸道病毒438株,检出率为74.87%,其中RSV病毒170株,PIV病毒84株,RhinoV病毒80株。病毒构成差异有统计学意义(χ2=573.4,P<0.05)。阳性标本中合并感染2种或2种以上病毒共66份,混合感染最多的是HBoV病毒。呼吸道病毒检出阳性率呈现单峰值分布,阳性率率从2014年的11月份开始上升,在12月份和2015年1-3月份达到峰值,4月开始下降。病毒阳性率随着年龄的增长呈现下降的趋势(χ2趋势=52.48,P<0.05)。检出WU多瘤病毒116株,检出率为19.83%。结论儿童急性下呼吸道感染以呼吸道合细胞病毒,副流感病毒为主,好发于冬春季节,随着患儿年龄的增加病毒分离率呈现下降趋势。

Objectives To analyze the pathogenic characteristics of acute lower respiratory tract infections and to provide evidence for diagnosis and control of acute respiratory tract infections in children. Methods Subjects were 585 children with an acute lower respiratory tract infection who were seen at the Second Hospital of Guangxi University of Science and Technology from August 2014 to July 2015.Samples of nasopharyngeal secretions were collected to detect 14 types of respiratory viruses commonly found in clinical settings. Results Four hundred and thirty-eight strains of respiratory viruses were detected in 585 samples,so viruses were detected at a rate of 74.87%.The 438 strains included 170 strains of RSV,84 strains of PIV,and 80 strains of RhinoV.Differences in the proportion of viral strains were statistically significant（χ2=573.4,P〈0.05）.Sixty-six samples were infected with 2or more types of viruses,and the virus most prevalent in a mixed infection was the HBoV virus.The rate at which samples tested positive for respiratory viruses peaked once.The rate at which samples tested positive increased starting in November 2014,it peaked from December 2014 to March 2015,and it began to decline in April.The rate at which samples tested positive virus with age tended to decrease（χ2趋势 =52.48,P〈0.05）.One hundred and sixteen strains of the WU polyomavirus were detected,accounting for19.83% of all strains. Conclusion Acute lower respiratory tract infections in children were mainly caused by respiratory viruses and influenza viruses and were more likely to occur in the winter and spring.The rate at which viruses were isolated tended to decrease in older children.