儿科重症监护室先天性心脏病合并呼吸道感染患儿的病毒性病原学研究

Study of viral etiology in children with respiratory tract infection complicated with congenitial heart disease inpediatric intensive care unit

目的总结儿科重症监护室中先天性心脏病合并呼吸道感染患儿的病毒性病原谱。方法收集2010年6月至2012年6月因呼吸道感染人住本院儿科重症监护室的患儿咽拭子标本622份，其中先天性心脏病合并呼吸道感染患儿咽拭子34份。应用多重聚合酶链反应（PCR）技术对呼吸道病毒进行检测，并对照分析合并先天性心脏病患儿的病毒性病原学特点。结果①34份先天性心脏病组咽拭子标本中，呼吸道病毒检测阳性20份（58．8％），588份非先天性心脏病组咽拭子标本中，呼吸道病毒检测阳性368份（62．6％）。②先天性心脏病组中，最常见的病毒分别为人鼻病毒（humanrhinovirus，HRV）8份，呼吸道合胞病毒（respiratorysyncytialvirus，RSV）6份，人博卡病毒（humanbocavirus，HBoV）4份，腺病毒（adenovlrus，ADV）2份；非先天性心脏病组中，最常见的病毒分别为HRV160份，RSV104份，ADV72份，HBoV50份；其他病毒阳性率较低。③先天性心脏病组中，混合病毒感染有2份（2／20，10．0％），非先天性心脏病组中，混合病毒感染有110份（110／368，29．9%）。结论本地区儿科重症监护室中先天性心脏病合并呼吸道感染患儿的病原体中病毒性病原体检出率高，以鼻病毒、呼吸道合胞病毒、人博卡病毒和腺病毒最常见，病毒谱和非先天性心脏病组相似。

Objective To investigate the viral pathogens spectrum in children with respitatory tract infection complicated with congenital heart disease in pediatric intensive care unit. Methods Nasopharyngeai aspirates specimens （NPA） specimens were collected from 622 children who were admitted to PICU with respiratory tract infection in our hospital from June 2010 to June 2011. Multiplex polymerase chain reaction （PCR） was applied to detected respiratory viruses, the character of viral pathogens of the positive cases were analysed. Results ①20 throat swab specimens tested positive for 34 cases with respitatory tract infection complicated with congenital heart disease of respiratory viruses （58.8%）, 368 throat swab specimens tested positive for 588 cases with respiratory tract infection of respiratory viruses （62.6%）. （2） Specimens tested positive for the virus in the group of children with respiratory tract infection complicated with congenital heart disease, the most common was human rhinovirus, there were 8 copies, followed by respiratory syncytial virus 6copies, human bocavirus 4 copies, there were 2 copies positive for adenovirus. Specimens tested positive for the virus in the group of children with respiratory tract infection, the most common was human rhinovirus, there were 160 copies, followedby respiratory syncytial virus 104 copies, adenovirus 72 copies, there were 50 copies positice for human Bocavirus. Other virus positive rate was low. （3） In the group of children with respiratory tract infection complicated with congenital heart disease, there were 2 cases of mixed infection （2/20, 10.0%）, in the group of children with respiratory tract infection, there were 110 cases of mixed infection （110/368, 29.9 %）. Conclusions There are high rate of detection of viral pathogens in children with respitatory tract infection complicated with congenital heart disease in Pediatric Intensive Care Unit in our hospital, the most common viruses are human rhinovirus, respiratory syncytial virus, human bocavirus and adenovirus. The viral pathogens spectrum is similar with the group of children with respiratory tract infection.