2881例儿童7种呼吸道病毒抗原检测的结果分析

Analysis on results of antigen detection of 7 kinds of respiratory tract viruse in 2881 children cases

目的了解绵阳地区儿童呼吸道病毒感染的分布、流行趋势,为儿童呼吸道病毒感染的早期诊断提供依据。方法采用直接免疫荧光法对绵阳市第三人民医院2016年1月至2019年1月2881例呼吸道感染患儿的流感病毒(IF)A、IFB、副流感病毒(PIV)1、PIV2、PIV3、呼吸道合胞病毒(RSV)及腺病毒(ADV)7种呼吸道常见病毒进行抗原检测,并对结果进行统计学分析。结果2881例呼吸道病毒检测的儿童中,813例呼吸道病毒检测为阳性,阳性率为28.22%。其中RSV为486例(59.87%),IFA为125例(15.38%),IFB为65例(8%),PIV3为63例(7.74%),ADV为43例(5.29%),PIV1为23例(2.83%),PIV2为8例(0.98%)。男、女患儿病毒感染的阳性率差异无统计学意义(P>0.05)。不同年龄段患儿感染病毒的阳性率比较,差异有统计学意义(P<0.05);<1岁、1~<3岁患儿病毒感染的阳性率高于其他年龄组,且两个年龄段均以RSV的阳性率最高(73.56%、63.24%)。春、夏、秋、冬4个季节病毒感染的阳性率比较,差异有统计学意义(P<0.05),秋、冬季节的感染率明显高于春、夏季节。秋、冬季节以RSV感染的阳性率最高(68.84%、62.60%),春、夏季节以PIV3感染率最高(39.47%、60.00%)。呼吸道病毒感染的疾病中以支气管炎的检出率最高(36.88%),其次为肺炎(33.69%),支气管肺炎(32.43%),上呼吸道感染(24.54%),最后为发热待诊(13.14%),抽搐(8.92%)。呼吸道病毒感染的不同疾病阳性率比较,差异有统计学意义(P<0.05)。在发热待诊、支气管肺炎、支气管炎、肺炎及抽搐中,呼吸道合胞病毒检出率最高,上呼吸道感染中以IFA的检出率最高。结论RSV是绵阳地区儿童呼吸道病毒感染的主要病原体,3岁以下儿童阳性率最高,秋、冬季节为呼吸道病毒感染的高发季节,常以下呼吸道感染为主。

Objective To understand the distribution and epidemic trend of child respiratory viral infection in Mianyan area to provide an evidence for the early diagnosis of child respiratory viral infections.Methods The direct immunofluorescent method was adopted to conduct the antigen detections in 7 kinds of common respiratory tract viruses including influenza virus A,B(IFA,IFB),parainfluenza virus 1,2,3(PIV1,PIV2,PIV3),respiratory syncytial virus(RSV)and adenovirus(ADV)in 2881 children cases of respiratory tract infection in the Mianyang Municipal Third People′s Hospital from January 2016 to January 2019.The detection results conducted the statistical analysis.Results Among 2881 cases of respiratory tract viral detection,there were 813 cases(28.22%)of positive with a positive rate of 28.22%,including 486 cases(59.87%)of RSV,125 cases(15.38%)of IFA,65 cases(8%)of IFB,63 cases(7.74%)of PIV3,43 cases(5.29%)of ADV,23 cases(2.83%)of PIV1 and 8 cases(0.98%)of PIV2.The positive rate of viral infection had no statistical difference between the male children and female children(P>0.05).The positive rate of viral infection had the statistical differences among different age groups(P<0.05).The positive rates of viral infection in the children<1 year old group and 1-<3 years old group were higher than those in the other age groups,moreover the positive rate of RVS in these two age groups were the highest(73.56%,63.24%).There was statistical difference in the positive rate of viral infection among different seasons of spring,summer,autumn and winter(P<0.05).The infection rate in winter and autumn was significantly higher than that in summer and spring.The positive rate of RSV infection was the highest in winter and autumn(68.84%,62.60%)and which of PIV3 was the highest in summer and spring(39.47%,60.00%).Among the diseases of respiratory tract viral infection,the detection rate of bronchitis was the highest(36.88%),followed by pneumonia(33.69%),bronchopneumonia(32.43%)and upper respiratory tract infection(24.54%),the final was the fever of unknown origin(13.14%)and convulsion(8.92%).The positive rate of respiratory tract viral infection had statistical difference among different disease(P<0.05).In the fever of unknown origin,bronchopneumonia,bronchitis,pneumonia and convulsion,the detection rate of RSV was the highest,which of IFA was the highest in the upper respiratory tract infection.Conclusion RSV is the main pathogen of child respiratory tract infection in Mianyang area,the positive rate is the highest in children under 3 years old,winter and spring are the high prevalence seasons of respiratory viral infection,which is dominated by the lower respiratory tract infection.