SARI监测中儿科肺炎病例9种呼吸道病毒特征分析

Characteristics of 9 respiratory viruses in pediatric pneumonia cases in SARI surveillance

目的了解新疆维吾尔自治区人民医院(简称人民医院)儿科住院严重呼吸道感染(severe acute respiratory infection,SARI)监测中肺炎病人感染呼吸道病毒病原学流行特征,为SARI监测中肺炎病例的治疗和防控提供线索。方法应用多重PCR方法检测2016年1月—2017年12月在人民医院儿科住院且出院诊断为肺炎的病例,以R语言统计学分析病例数据。结果 2016—2017年人民医院儿科出院诊断为肺炎的SARI病例主要症状为咳嗽(97.98%,χ~2=0.654)、咳痰(48.27%,χ~2=2.692)、听诊呼吸音异常(28.90%,χ~2=0.589),病毒组和非病毒组症状差异无统计学意义(P>0.05)、发病至住院时间间隔差异有统计学意义(t=2.203,P=0.028);346份样本中检出病毒224次、检出率64.74%,检出次数从高到低依次为呼吸道合胞病毒61次、流感病毒51次、副流感病毒30次、鼻病毒25次、偏肺病毒21次、腺病毒20次、冠状病毒7次、博卡病毒7次、肠道病毒2次,各亚型均有检出;多重感染率6.36%,36个月以上组感染呼吸道合胞病毒(χ~2=6.506,P=0.011)和乙型流感病毒(χ~2=10.206,P=0.001)与36个月及以下组比较差异有统计学意义,13.29%住院期间收住ICU,36个月及以下组9种病原均有病例入住ICU。结论儿科肺炎住院病例以呼吸道合胞病毒和流感病毒感染为主;从症状和入院前时间无法准确区分病原,快速诊断病原可为治疗和不同病毒感染病例的隔离提供依据。

Objective To understand the etiological and epidemiological characteristics of respiratory virus infection in pediatric patients under the surveillance of severe acute respiratory infection(SARI)in People's Hospital of Xinjiang Uygur Autonomous Region(brief in People's Hospital),and provide the clues for treatment,prevention and control.Methods Multiple PCR methods were taken to detect the cases of pneumonia in pediatric department of People's Hospital from January 2016 to December 2017,and data of the cases were analyzed by software of R language.Results The cardinal symptoms of the SARI cases diagnosed as pneumonia in the pediatrics department of People's Hospital from 2016 to 2017 were cough(97.98%,χ2=0.654),expectoration(48.27%,χ2=2.692)and abnormal respiratory sounds(28.90%,χ2=0.589),without statistical difference(P>0.05)between the viral infection group and the non-viral infection group.There was statistical difference(t=2.203,P=0.028)in the time interval from onset to hospitalization between the two groups.The viruses were detected 224 times from 346 samples,with detection rate of 64.74%.The number of times of virus detection from high to low was 61 times of respiratory syncytial virus,51 times of influenza virus,30 times of parainfluenza,25 times of rhinovirus,21 times of human metapneumovirus,20 times of adenovirus,7 times of coronavirus,7 times of bocavirus,and 2 times of enterovirus.All subtypes were detected.The multiple infection rate was 6.36%.There were statistical differences in respiratory syncytial virus infection(χ2=6.506,P=0.011)and influenza B virus infection(χ2=10.206,P=0.001)between the age group of 36 months and elder and the age group under 36 months.There were 13.29%of cases admitted to ICU during hospitalization,and the cases with 9 types of virus in the age group under 36 months were admitted to ICU.Conclusions The hospitalized pneumonia cases in the pediatric department are mainly infected with respiratory syncytial virus and influenza virus.The pathogen could not be accurately identified in the time interval from onset to hospitalization.Rapid detection for the pathogen could provide evidence for treatment and the isolation of the cases infected with different virus.