沈阳地区春季呼吸道感染患儿病毒病原学分析

Etiological analysis of virus in children with respiratory tract infection during spring in Shenyang regions

目的分析沈阳地区呼吸道感染患儿常见呼吸道病毒的感染情况,为临床疾病的诊治提供参考。方法选择2018年2月至5月在中国医科大学附属盛京医院就诊的临床诊断为呼吸道感染患儿756例,采用直接免疫荧光法对患儿鼻咽拭子进行呼吸道合胞病毒(respiratory syncytial virus,RSV)、腺病毒(adenovirus,ADV)、甲型流感病毒(influenza virus A,INF-A)、乙型流感病毒(influenza virus B,INF-B)、副流感病毒(parainfluenza virus,PINF)Ⅰ型、Ⅱ型和Ⅲ型等呼吸道病毒抗原进行检测,并分析相关病毒感染情况。结果在756例患儿中,病毒抗原阳性214例,占28.31%。在单一病毒感染患儿中,RSV的检出率最高,占所有患儿的11.38%,占单一病毒感染患儿的47.78%。在混合病毒感染患儿中,主要是RSV合并其他病毒感染,占混合病毒感染患儿的73.53%。男性患儿呼吸道病毒检出率30.07%,明显高于女性患儿(25.99%,χ^2=3.982,P=0.046),且以RSV感染和混合感染为主。不同年龄组的病毒检出率也有所不同,年龄越小,检出率越高(χ^2=14.216,P=0.007),小于6个月患儿病毒检出率最高(39.73%),且以RSV检出居多(75.86%)。呼吸道相关性疾病不同临床诊断的病毒检出率比较,差异无统计学意义。结论2018年2月至5月沈阳地区呼吸道病毒感染患儿以RSV感染为主,小于6个月患儿呼吸道病毒感染率较高,且主要是RSV感染。

Objective To investigate the distribution of respiratory viruses in the throat swabs from children with respiratory tract infection in Shenyang and provide reference for the diagnosis and treatment of clinical diseases. Methods A total of 756 children with respiratory tract infection who were admitted to Shengjing Hospital of China Medical University in Shenyang from February 2018 to May 2018 were enrolled in this study.The antigens of influenza virus A (INF-A), influenza virus B (INF-B), adenovirus (ADV), respiratory syncytial virus (RSV), and parainfluenza virus types I,Ⅱ, and Ⅲ(PIV-Ⅰ, PIV-Ⅱ and PIV-Ⅲ) in nasopharyngeal swabs were detected by direct immunofluorescence. Results Of all the 756 throat swabs from hospitalized children, 214 (28.31%) had positive virus detection results.RSV (11.38%) had the highest detection rate in single-positive cases, accounting for 47.78% of single positive cases.In mixed virus infection, RSV combined with other viral infections accounted for 73.53% of mixed virus infections, and RSV was the main pathogen found in the study population.Analysis of the detection rate of virus infection related with age and gender showed that the younger the age, the higher the detection rate(χ^2=14.216, P=0.007). The detection rate of patients younger than 6 months was 39.73% and RSV was the mostly detected pathogen (75.86%). The detection rate of male patients was 30.07%, which was higher than that of female patients with 25.99%(χ^2=3.982, P=0.046), and RSV infection and mixed infection were the major.There was no significant difference in virus detection rates between patients with different clinical diagnoses. Conclusion RSV is the main pathogen during spring from February 2018 to May 2018 in Shenyang.The virus detection rate of patients younger than 6 months is higher and RSV is the mostly detected pathogen.