2011年至2014年无锡地区儿童急性呼吸道病毒感染病原谱研究

Study on viral etiology of acute respiratory tract infections in children in Wuxi area during 2011-2014

目的：了解无锡地区儿童感染呼吸道病毒的流行特征和流行规律。方法收集2011年6月至2014年12月无锡市儿童医院因急性呼吸道感染就诊的患儿2747例，采用反转录-PCR 检测甲型流感病毒、乙型流感病毒、副流感病毒Ⅰ～Ⅳ型、腺病毒、呼吸道合胞病毒、人偏肺病毒、人博卡病毒、冠状病毒和鼻病毒。计数资料的比较采用χ^2检验。结果所检2747份标本中，856份标本病毒核酸检测为阳性，阳性率为31．16％。各季节病毒检出情况分布不均，高峰出现在冬、春季。1～＜2岁组呼吸道病毒检出率最高，达40．18％；6～＜12岁组为32．63％。各种呼吸道病毒中甲型流感病毒检出最多，占7．54％（207／2747）；其次是副流感病毒，占6．95％（191／2747）；乙型流感病毒占4．22％（116／2747）。≥2种呼吸道病毒混合感染的标本有84份，阳性率为3．06％（84／2747）。结论2011年至2014年无锡地区儿童急性呼吸道感染中甲型流感病毒最为常见，1～＜2岁组呼吸道病毒检出率最高；副流感病毒几乎全年均有散发，其余呼吸道病毒多以冬春交替流行为主。

Objective To investigate the epidemiology of respiratory viruses in children from Wuxi area.Methods A total of 2 747 cases of children diagnosed with acute respiratory infection in Wuxi during 2011 —2014 were collected.Reverse transcription-polymerase chain reaction was used to detect nine kinds of respiratory viruses,including influenza virus A （Flu A）,influenza virus B （Flu B）,parainfluenza virus （PIV）Ⅰ-Ⅳ,adenovirus （ADV）,respiratory sycytial virus （RSV）,human metaneumovirus （hMPV）, human bocavirus （HBov）,human coronaviruses （hCov）and human rhinovirus （HRV）.The categorical data were compared using chi square test.Results A total of 856 among the 2 747 samples were tested positive for respiratory virus nucleic acid,with the positive rate of 31 .16%.The viral distribution was uneven in different seasons,and the infection peaked in winter and spring.The virus detection rate was highest in age 1 to 2 year group （up to 40.18%）,and followed by age 6 to 12 year group （32.63%）.Flu A virus was the most frequently detected virus,accounting for 7.54% （207/2 747）;followed by PIV, accounting for 6.95 % （191/2 747）;and Flu B accounted for 4.22%（116/2 747）.There were 84 cases of mixed infection of two or more kinds of respiratory viruses,with positive rate of 3.06% （84/2 747 ）. Conclusions Our study suggests that Flu A is the most common pathogen in children with acute respiratory infections in Wuxi area during 2011 —2014;virus detection rate is highest in age 1 to 2 year group;and parainfluenza virus is almost detected throughout the year,while the rest of respiratory viruses are commonly seen in winter and spring.