河北地区老年患者呼吸道感染病毒病原谱特征及分析

The Analysis of Characteristics of Viral Etiology of Respiratory Tract Infections in Elderly Patients in Hebei Province

目的了解河北地区老年患者呼吸道感染的流行病学及病原谱特征,为临床规范老年呼吸系统感染的诊断和治疗提供依据和指导。方法收集2016年1月至2018年12月老年科住院患者的痰液标本,采用多重RT-PCR技术,检测13种呼吸道病原体。结果533份标本中,阳性检出率为65.5%,男性与女性的阳性检出率分别为61.2%和71.8%,差异具有统计学意义(P=0.01),但其病原谱特征差异无统计学意义(P=0.372);不同年龄组的阳性检出率及病原谱特征差异无统计学意义(P=0.33;P=0.25)。在349份阳性标本中,甲型流感病毒阳性检出率最高(19.1%),其次为鼻病毒(12.8%)和乙型流感(11.1%);两种以上病原体混合感染占28.7%。不同季节、年份病原体流行趋势也有所不同。结论河北地区老年患者呼吸道感染的主要病原体为人流感病毒、鼻病毒和腺病毒,且普遍存在混合病毒感染。进一步监测和探究其流行规律,对本地区老年患者呼吸道感染的诊断和治疗具有重要意义。

Objective To understand the epidemiological characteristics of respiratory tract infection in elderly patients in Hebei province,so to provide the evidence and guidance for clinical standardization of diagnosis and treatment of respiratory system infection in the elderly patients.Methods Sputum specimen from hospitalized patients in the geriatric department during January,2016 to December,2018 were collected and 13 respiratory pathogens were detected by multiple RT-PCR technique.Results In 533 samples,the positive rate was 65.5%,among which 61.2%in male and 71.8%in female with the significant difference(P=0.01),but there was no significant difference in etiological spectrum characteristics(P=0.372).There was no significant difference in positive detection rate and etiological spectrum among different age groups(P=0.33;P=0.25).Among the 349 positive samples,the positive rate of influenza A virus was the highest(19.1%),followed by rhinovirus(12.8%)and influenza B(11.1%).There were 100 cases of mixed infection with more than two pathogens,accounting for 28.7%.The epidemic trend of pathogens was also different across different seasons and years.From 2016 to 2018,human influenza virus,rhinovirus and adenoviruses were the main viruses in Hebei province.Conclusion The main pathogens of respiratory tract infection in elderly patients in Hebei might be human influenza virus,rhinovirus and adenovirus,and mixed virus infection is common.Further monitoring and exploration of its epidemic law is of great significance for the diagnosis and treatment of respiratory tract infection in elderly patients in this area.