急性下呼吸道感染住院儿童的病毒病原学分析

Viral etiological analysis of hospitalized children with acute lower respiratory tract infection

目的分析住院儿童急性下呼吸道感染(ALRTI)的病毒病原学特征。方法回顾性分析2017年1~12月深圳市儿童医院住院部诊治的3 682例ARLTI患儿,调取患儿临床资料以及RT-PCR病毒检测结果,分析致儿童ALRTI常见的病毒构成比以及在不同年龄、性别、季节的分布特征。结果 3 682例鼻咽分泌物样本中检出病毒2 530例,检出率为68.71%,其中呼吸道合胞病毒(RSV)检出率最高(27.51%),其次是甲型流感病毒(IVA)(14.64%)、乙型流感病毒(IVB)(8.28%)、腺病毒(ADV)(5.84%);男性患儿中病毒检出率为69.00%(1 407/2 039),女性检出率为68.35%(1 123/1 643),差异无统计学意义(P>0.05);人博卡病毒(HBo V)、人偏肺病毒(h MPV)在男性患儿检出率分别为4.22%、2.31%,与女性患儿的1.58%及1.22%比较差异均有统计学意义(P<0.05);6~12个月龄患儿病毒检出率为93.65%(752/803),高于其他年龄组,差异均有统计学意义(P<0.05);呼吸道病毒以10~12月份检出率最高,占86.39%(1 549/1 793),明显高于其他时间段,差异均有统计学意义(P<0.05),其中RSV、IVA、IVB在10~3月份检出率最高,ADV在4~6月检出率高,HRV在4~9月份检出率最高,HBo V在7~9月份检出率最高,h MPV在4~6月份检出率最高。结论儿童ALRTI中,RSV、IVA、IVB、ADV最为常见,6~12个月龄儿童、冬春季节病毒检出率最高。

Objective To analyze the viral etiological characteristics of acute lower respiratory tract infection（ALRTI） in hospitalized children. Methods A retrospective analysis was performed on 3 682 cases of ARLTI patients,who admitted to Inpatient Department of Shenzhen Children＇s Hospital from January 2017 to December 2017. The clinical data and the detection results of RT-PCR for virus were used to analyze the common virus composition ratio and the distribution characteristics of different ages, gender and season in children with ALRTI. Results Among 3 682 cases of nasopharyngeal secretion, virus was detected in 2 530 cases with the detection rate of 68.71%. The detection rate of respiratory syncytial virus（RSV） was highest（27.51%）, followed by influenza A virus（IVA）（14.64%）, influenza B virus（IVB）（8.28%）, adenovirus（ADV）（5.84%）. There was no significant difference in the detection rate of virus between male patients and female patients with 69.00%（1 407/2 039） versus 68.35%（1 123/1 643）（P〈0.05）. The detection date of human Boka virus（HBo V） and human partial lung virus（h MPV） in male patients were respectively 4.22% and 2.31%, and there were significant differences compared with corresponding 1.58% and 1.22% in female patients（P〈0.05）. The virus detection rate of 6-12-month-old children was 93.65%（752/803）, which was significantly higher than that of other age groups（P〈0.05）. The detection rate of respiratory virus during October to December was 86.39%（1 549/1 793）, which was significantly higher than that of the other time period（P〈0.05）. The detection rate of RSV, IVA, IVB during October to March was highest, and the detection rate of ADV, HRV, HBo V, h MPV were highest during April to June, April to September, July to September, April to June, respectively. Conclusion Among children with ALRTI, RSV, IVA, IVB and ADV are the most common, and the virus detection rate of 6-12 months old during winter and spring season is the highest.