杭州市儿童急性呼吸道Saffold心病毒感染的临床特征及流行病学分析

Clinical and epidemiological characteristics of Saffold virus infection in children with acute respiratory tract infection in Hangzhou

目的 了解杭州地区Saffold心病毒（SAFV）在急性呼吸道感染（ARI）患儿中的临床特征和流行病学特征.方法 收集2011年3月至2014年2月浙江大学医学院附属儿童医院呼吸道门诊和住院病例共1060例.其中门诊病例采集咽拭子256份,住院病例采集气管吸取物804份.实时荧光PCR扩增SAFV的5＇UTR基因片段.采用SPSS 17.0软件分析检测结果和临床资料.结果ARI门诊患儿和住院患儿样本中SAFV的检出率分别是2.3%（6/256）和13.2%（106/804）,两者相比差异具有统计学意义（χ^2=24.147,P〈0.01）.住院病例中,〈1岁、1~〈3岁、3~〈6岁和6~12岁患儿阳性检出率分别为14.0%、11.2%、11.1%和8.3%,各年龄组间相比,差异无统计学意义（χ^2=1.845,P〉0.05）;男性和女性患儿 SAFV 检出率分别为12.7%和17.7%（χ^2=0.279,P 〉0.05）;按季节划分,SAFV检出率最高的是秋季（21.2%）,其次是春季（14.6%）,冬季（9.5%）和夏季（8.8%）检出率相对较低（χ^2=15.625,P〈0.01）.106例SAFV阳性住院患儿中,81例存在合并感染,合并感染率为76.4%.6例门诊病例中,4例存在合并感染,合并感染率为66.7%.住院病例中,与SAFV合并感染率最高的是呼吸道合胞病毒（36.8%）,其次为鼻病毒（27.4%）、偏肺病毒（10.4%）和副流感病毒（10.4%）.ARI患儿中,SAFV阳性病例的发热率低于SAFV阴性病例（χ^2=4.069,P〈0.05）.结论 杭州地区ARI住院患儿中SAFV的检出率显著高于门诊患儿,SAFV感染均以合并感染为主.SAFV在杭州地区的流行呈现一定地方流行模式.

Objective To investigate the clinical and epidemiological characteristics of Saffold virus （SAFV）infection in outpatient and hospitalized children with acute respiratory tract infections（ARI）. Methods A total of 1060 clinical specimens were collected from children with ARI in the Affiliated Children＇s Hospital,Zhejiang University School of Medicine from March 2011 to February 2014, including 256 samples of throat swabs from outpatients,and 804 samples of trachea suctions from hospitalized patients. Real time PCR（RT-PCR）was performed to detect 5＇UTR segment of SAFV.SPSS 17.0 software was used to analyze the test results and clinical data.Results The positive detection rates of SAFV in outpatients and hospitalized children with ARI were 2.3%（6/256）and 13.2%（106/804）, respectively（χ^2=24.147, P〈0.01）.Among the hospitalized children,the positive detection rates of SAFV in children 〈1 year,1-〈3 years,3-〈6 years and 6-12 years were 14.0%,11.2%,11.1% and 8.3%, respectively（χ^2=1.845,P〉0.05）.The positive rates of SAFV in males and females were 12.7% and 17.7%（χ^2=0.279,P〉0.05）.The detection rate of SAFV in autumn was highest（21.2%）, followed by that in spring （14.6%）,winter（9.5%）and summer（8.8%）（χ^2=15.625, P〈0.01）.The co-infection rates with other respiratory pathogens of hospitalized and outpatients children were 76.4%（81/106）and 66.7% （4/6）.Among the hospitalized patients, the rate of co-infection with respiratory syncytial virus was the highest（36.8%）,followed by rhinovirus（27.4%）, metapneumovirus（10.4%）and parainfluenza virus （10.4%）.Among children with ARI,the fever rate of SAFV-positive cases was lower than that of SAFV-negative cases（χ^2=4.069,P〈0.05）.Conclusions The detection rate of SAFV in hospitalized children with ARI is significantly higher than that in outpatients,and SAFV infection was dominated by co-infection. The prevalence of SAFV in the Hangzhou area presents a certain local epidemic pattern.