绍兴市呼吸道感染患儿常见病毒抗原检测结果分析

Pathogenic analysis of children with common respiratory virus infections in Shaoxing city of China

目的了解绍兴市儿童呼吸道病毒感染常见病毒类型、流行特点及相关检验指标特征,为临床的诊断与预防提供依据。方法以2019年1月—2020年8月在绍兴市妇幼保健院就诊的4269例呼吸道感染患儿为研究对象,采用直接免疫荧光法对采集的鼻咽拭子进行7种常见呼吸道病毒抗原检测,包括腺病毒(adenovirus,ADV)、流感病毒A、B(influenza virus,Flu A/B)、副流感病毒1、2、3(parainfluenza virus,PIV-1、PIV-2、PIV-3)及呼吸道合胞病毒(respiratory syncytial virus,RSV)。结果绍兴市妇幼保健院就诊的儿童呼吸道感染病例中,呼吸道病毒抗原阳性率为9.56%(408/4269),其中RSV的阳性率最高(7.03%,300/4269),2020年1—8月仅有2例标本检测结果为阳性。1~<3岁患儿的病毒检测阳性率最高(14.75%,212/1437),1~<3岁患儿的PIV-3(2.23%,32/1437)和RSV(11.76%,169/1437)检出率明显高于其他年龄组(χ^(2)=20.773、85.128,P均<0.01)。冬季呼吸道病毒阳性检出率最高(16.11%,159/987),冬季Flu A(0.71%,7/987)和RSV(12.87%,127/987)的检出率高于其他季节(χ^(2)=11.089、96.970,P均<0.05),秋季PIV-3(1.98%,20/1012)的检出率最高(χ^(2)=8.036,P<0.05)。呼吸道病毒感染患儿白细胞计数[(5.1±1.9)×10^(9)/L]和中性粒细胞百分比[(40.8±11.3)%]低于正常值,而淋巴细胞百分比(64.7±11.5)%高于正常值。结论RSV是绍兴地区儿童呼吸道病毒感染的主要病原体,1~<3岁儿童的呼吸道病毒阳性率最高,冬季为呼吸道病毒感染高发季节。

Objective To study the virus types,prevalence characteristics and test index of children with respiratory virus infections in Shaoxing district of China.Methods A total of 4269 cases were collected in Shaoxing Women and Children′s Hospital from January 2019 to August 2020.Adenovirus(ADV),influenza virus(IFA,IFB),parainfluenza virus(PIV-1,PIV-2,PIV-3)and respiratory syncytial virus(RSV)were detected by direct immunofluorescence.Results Of all collected specimens,408 were tested positive for respiratory virus antigens(9.56%,408/4269)with RSV at the highest.Only two specimens were tested positive from January to August 2020.The positive rate of virus infection in the age group of 1-3 years was the highest,with PIV-3 infection at 2.23%(32/1437)and RSV at 11.76%(169/1437)(χ^(2)=20.773,85.128;P<0.01).The positive rate of virus infection in winter was the highest,with Flu A infection at 0.71%(7/987)and RSV at 12.87%(127/987)(χ^(2)=11.089,96.970;P<0.05).The positive rate of PIV-3(1.98%,20/1012)infection was the highest in autumn(χ^(2)=8.036,P<0.05).The white blood cell count[(5.1±1.9)×10^(9)/L]and the percentage of neutrophils[(40.8±11.3)%]in children with respiratory virus infection were lower than normal values,while the percentage of lymphocytes[(64.7±11.5)%]was higher than normal.Conclusions RSV is the main pathogen of respiratory virus infections in children in Shaoxing city of China,and the positive rate of children 1-3 years old is the highest,and winter is the high-incidence season of infection.