476例人腺病毒感染患儿的流行病学和临床特征

Epidemiology and clinical features of human adenovirus infection in 476 children

目的了解住院急性呼吸道感染患儿人腺病毒(HAdV)感染流行病学及临床特征。方法以2016年12月至2018年12月在河北省儿童医院住院的急性呼吸道感染患儿中确证为HAdV感染的476例患儿为研究对象,分析其流行特点、临床特征以及混合感染情况。结果急性呼吸道感染患儿中HAdV总检出率为4.78%(476/9962),全年均有检出,11月为流行高峰。6岁以下患儿HAdV检测阳性率随年龄增加而增加,各年龄组检出率比较差异有统计学意义(χ^2=158.700,P<0.01)。>1~3岁组是HAdV感染高发年龄,共202例(42.44%);HAdV呼吸道感染疾病构成中支气管肺炎约占60%,在各年龄段均占首位。HAdV血清型检测结果提示,3型和7型为主要血清型,HAdV-3多表现为支气管肺炎,而重症及致死性患儿多为HAdV-7感染。为感染总混合感染率为61.76%(294例),且随感染在呼吸道向下蔓延,混合感染率逐渐升高,各病种混合感染率比较差异有统计学意义(χ^2=31.398,P<0.01),混合感染病原以鼻病毒为主。结论HAdV感染全年均可发生,>1~3岁是其高发年龄,可导致全呼吸道感染,支气管肺炎占60%左右,HAdV-3和HAdV-7是主要血清型,腺病毒存在较高混合感染率,且随感染在呼吸道向下蔓延混合感染率增加。

Objective To investigate the epidemiological and clinical characteristics of human adenovirus(HAdV)infection in hospitalized children with acute respiratory tract infection.Methods From December 2016 to December 2018,476 children with acute respiratory tract infection confirmed as HAdV infection in Hebei Children's Hospital were enrolled,and the epidemic characteristics,clinical featurse and mixed infection of HAdV were analyzed.Results The total detection rate of HAdV in children with acute respiratory infection was 4.78%(476/9962),which was detected all year round,and the epidemic peak was in November.The positive rate of HAdV detection in children under 6 years old increased with the age,and there was a significant difference among different age groups(χ^2=158.700,P<0.01).Children aged>1-3 years old had the high incidence of HAdV infection,accounting for 42.44%(202 cases).Bronchopneumonia accounted for about 60%of HAdV respiratory tract infections,and it took the first place in all age groups.HAdV-3 and HAdV-7 were the main serotypes.HAdV-3 mainly caused bronchopneumonia,while HAdV-7 was related to severe and fatal cases.The total mixed infection rate was 61.76%(294 cases).With the downward spread of infection in respiratory tract,the mixed infection rate gradually increased,and there was a significant difference among different diseases(χ^2=31.398,P<0.01).Rhinovirus was the main pathogen of mixed infection.Conclusions HAdV infection can occur all year round,and high incidence age is>1-3 years old.HAdV can lead to whole respiratory tract infection,in which bronchopneumonia accounts for about 60%.HAdV-3 and HAdV-7 are the main serotypes.HAdV has a high mixed infection rate which increases with the downward spread of infection in respiratory tract.