618例儿童呼吸道感染的病毒病原学分析

Analysis of viral etiology in 618 children with respiratory tract infection

目的了解儿童常见呼吸道病毒感染的发生率，比较不同年龄段儿童呼吸道感染的病毒检出情况，并分析儿童喘息症状与病毒感染的关系。方法以618例呼吸道感染住院患儿为研究对象，取其鼻咽分泌物进行七项呼吸道病毒抗原检测并分析其结果，包括呼吸道合胞病毒（RSV）、腺病毒（ADV）、甲型流感病毒（IFA）、乙型流感病毒（IFB）、副流感病毒Ⅰ、Ⅱ、Ⅲ（PIVⅠ、Ⅱ、Ⅲ）。结果（1）618例送检标本中，166例阳性，总阳性率为26．86％，其中RSV最高，阳性率为17．96％，其余依次为PIVⅢ（5．99％），IFA（1．62％），ADV（0．81％），PIVⅠ（0．49％）；混合感染1例，阳性率为0．16％，为RSV与PIVⅠ混合感染。（2）14d～〈1岁、1岁～〈3岁、3岁～〈6岁及≥6岁不同年龄组病毒检出阳性率依次为35．04％、18．25％、17．11％、9．26％。（3）不同呼吸道感染性疾病病毒检出率不同，以毛细支气管炎检出率最高，为47．37％。（4）所检测呼吸道感染患儿中婴幼儿更易出现喘鸣体征，喘息患儿中以RSV检出阳性率最高，为42．17％。结论RSV和PIVⅢ是儿童呼吸道感染的最常见病毒；呼吸道感染的儿童年龄越小，越容易发生病毒感染；喘息患儿中RSV感染率最高。

Objective To investigate the incidence of the common respiratory viruses in children with respiratory tract infection and to compare the results among different ages and to analyze the relationship between wheezing of children and various viruses. Methods Nasopharyngeal secretions of 618 children with respiratory infection hospitalized were assayed for 7 respiratory viruses, including respiratory syncytial virus, adenovirus,in fluenza A virus, influenza B virus, parainfluenza virus Ⅰ 、 Ⅱ 、 Ⅲ. Results （ 1 ） A total of 166 cases, affected with viral etiology,were detected in 618 samples, and the total positive rate was 26. 86%. The most common virus was RSV （ 17.96% ）, followed by PIV Ⅲ （ 5.99% ）, IFA （ 1.62% ）, ADV （ 0. 81% ）, PIV Ⅰ （ 0.49 % ）. Moreover, 1 case infected with RSV and PIVI was included, with the positive rate 0. 16%. （2）The positive rates were different in various ages,with 14d ～ 〈 1-year 35.04%, 1 - 〈 3-year 18. 25% ,3 ～ 〈 6-year 17. 11% and 〉16- year 9. 26%. （3）There were differences of positive rate of viruses among different respiratory infectious diseases, and capillary bronchitis occupied the highest percentage（47.37% ）. （4）Among all the detected children, infants were more likely to whee in auscultation of lung, and RSV was the primary etiology. Conclusion RSV, which was the primary viral etiology in children with wheezing, was the most common virus leading to respiratory infection of children, followed by PIV Ⅲ. In the children with respiratory tract infection, the viral infection tends to occur in younger children.