小儿呼吸道合胞病毒A、B亚型的流行病学特征及临床表现

Epidemiological features and clinical manifestations of children with respiratory syncytial virus of subtype A and B

目的分析小儿呼吸道合胞病毒（h RSV）A、B亚型的流行病学特征及临床表现。方法选择2014~2015年重庆三峡中心医院江南分院以呼吸道感染首诊的500例患儿为研究对象。将鼻咽吸取物标本采用直接免疫荧光及RT-PCR方法筛选出h RSV感染阳性标本,通过核酸电泳法鉴定A、B亚型。对照分析h RSV感染的A、B亚型患儿的年龄、性别、住院时间;分析A、B亚型流行病学特征及临床表现差异。结果 h RSV感染阳性患者200例,其中,A亚型71例（35.5%）,B亚型129例（64.5%）。h RSV A、B亚型患儿中,男性多于女性,间质性肺炎、毛细支气管占比高于支气管肺炎、支气管炎、哮喘急性发作。h RSV A、B亚型感染的患儿均以咳嗽、喘息为主要症状,其次为鼻塞流涕、发热、呼吸困难,h RSV A亚型与B亚型各症状占比比较,差异均无统计学意义（P〉0.05）。h RSV A、B亚型感染患儿中,≤6个月患儿占比最高,且随着年龄的增长,患儿所占比例明显降低;≤6个月、〉6~12个月、〉1~2岁、〉2~5岁h RSV A亚型与B亚型患儿占比比较,差异无统计学意义（P〉0.05）。每年1、2月及11、12月是h RSV感染的高峰期,不同月份A、B亚型患儿的感染情况差异无统计学意义（P〉0.05）。结论 2014~2015年h RSV A、B两亚型在重庆地区共同流行,以B亚型优势流行为主。两亚型在临床表现、年龄等方面并无明显差异。h RSV A、B亚型的分布均与年龄、月份有关,h RSV A、B亚型均以咳嗽、喘息为主要临床表现。

Objective To analyze the epidemiological characteristics and clinical manifestations of subtype A and B of respiratory syncytial virus（h RSV）. Methods From 2014 to 2015, 500 children with respiratory tract infection first diagnosed in Jiangnan Branch Hospital of Chongqing Three Gorges Central Hospital were selected as the research objects.Children with h RSV infection was screened by the method of direct immunofluorescence and RT-PCR, and classified into subtype A and B by nucleic acid electrophoresis. Age, gender, length of hospital stay of patient with subtype A and B of h RSV infection were compared; epidemiological features and clinical manifestations of patient with subtype A and B were analyzed. Results 200 cases of HRSV infection were detected, of which 71 cases（35.5%） with subtype A of h RSV infection, and 129 cases（64.5%） with subtype B infection. In children with subtype A and B of h RSV infection,boys were more than girls, proportions of interstitial pneumonia and capillary bronchus were higher than bronchial pneumonia, bronchitis, asthma acute author. Cough and breathing were the main symptoms of children with subtype A and B of HRSV infection, followed by stuffy nose, runny nose, fever, difficulty breathing; there was no statistically significant difference in the clinical manifestations between subtype A and B of h RSV（P〈0.05）. 0-6 months children with the highest proportion in children with subtype A and B of h RSV infection, and as the growth of the age, the proportion was significantly lower; there was no statistically significant difference in the proportion of children aged≤ 6 months, 6-12 months, 1-2 years, and 2-5 years between subtype A and B of h RSV（P〈0.05）. January,February, December and November every year were the peak of h RSV infection; there was no statistically significant difference in proportion of children with subtype A and B of h RSV at different months（P〈0.05）. Conclusion Distribution of subtype A and B of h RSV is common popular from 2014 to 2015 in Chongqing, and give priority to subtype B of h RSV. There is no obvious difference of two subtypes in clinical manifestations, age. The distribution of subtype A and B of h RSV is related to age and month, coughing and wheezing are the main manifestations of two subtypes.