急性下呼吸道感染住院儿童副流感病毒流行特征及临床症状研究

Epidemiological and clinical characteristics of human parainfluenza viruses in hospitalized children with acute lower respiratory tract infections

目的分析上海市急性下呼吸道感染住院儿童中副流感病毒(human parainfluenza virus,HPIV)不同亚型(HPIV1~4)流行特征及临床症状,评估HPIV4在儿童下呼吸道感染中的作用.方法收集2015年1月至2017年12月上海市儿童医院0~14岁急性下呼吸道感染住院患儿鼻咽抽吸物样本,共5030份.逆转录荧光PCR法检测HPIV1~4型和其他常见5种呼吸道病原体,x2检验比较HPIV1~4型流行特征及临床症状差异.结果 5030例患儿中,HPIV1阳性138例(2.74%),HPIV2阳性31例(0.62%),HPIV3阳性432例(8.59%),HPIV4阳性171例(3.40%).HPIV阳性病例与其他5种常见病毒合并感染率为10.23%(79/772).HPIV1~4在不同月龄患儿及不同季节中检测阳性率比较,差异均具有统计学意义.与HPIV3相比,HPIV4的患儿在发热、咳嗽、流涕、腹泻等症状方面,差异均具有统计学有意义.结论上海市儿童急性下呼吸道感染中HPIV4阳性率仅低于HPIV3,应引起临床重视.

Objective To investigate the epidemiological and clinical characteristics of human parainfluenza virus (HPIV) types 1 to 4 (HPIV1 to 4) infections among hospitalized children with acute lower respiratory tract infections, so as to evaluate the effects of HPIV4 on lower respiratory tract infections in children. Methods From January, 2015 to December, 2017, a total of 5 030 nasopharynal aspirate samples were collected from hospitalized children aged 0-14 years old with acute lower respiratory tract infections in Children's Hospital of Shanghai. Reverse transcript fluroscent PCR was used to detect HPIV1-4 and five other common respiratory viruses. The differences of epidemiological and clinical characteristics of HPIV1 to 4 were analyzed by chi-square test. Results From 5 030 child patients, 138 were positive of HPIV1 (2.74%), 31 were positive of HPIV2 (0.62%), 432 were positive of HPIV3 (8.59%) and 171 were positive of HPIV4 (3.40%). Co-infection rate of HPIV with 5 other common respiratory viruses were 10.23%(79/772). The differences of the positive rates of HPV1 to 4 among children of different ages and among different seasons were statistically significant. Comparing to HPIV3, children with HPIV4 infections showed statistically significant differences in clinical features, including cough, fever and diarrhea. Conclusions The positive rate of HPIV4 in child patients of acute lower respiratory tract infections was only lower than that of HPIV3. This should be concerned in clinical practice.