住院患者急性呼吸道病毒感染流行病学特征及干预措施

Epidemiological study and intervention measures of acute respiratory virus infection in hospitalized patients

目的了解住院患者急性呼吸道病毒感染的流行病学特征,为临床诊疗提供参考,制定相关干预措施。方法选取成都医学院附属中医医院2019年3月至2021年3月收治呼吸道病毒感染住院患者414例,采用免疫荧光法定性检测副流感病毒1-3型、甲型流感病毒、呼吸道合胞病毒(RSV)、乙型流感病毒、腺病毒。结果414例ARTI患者中呼吸道病毒阳性例数为84例,阳性检出率为20.29%(84/414),单一病毒感染阳性患者为76例,阳性检出率为18.36%(76/414);混合感染性患者为8例,阳性检出率为1.93%(8/414),病毒感染最常见的病原体为甲型流感病毒(25.00%)、乙型流感病毒(20.23%)和RSV(17.86%)。不同年龄段ARTI患者病毒阳性检出率差异有统计学意义(χ^(2)=84.692,P<0.05);1~8岁月组呼吸道病毒检出率最高(38.93%)。7种病毒阳性检出率差异有统计学意义(P<0.05);病毒混合感染患者在主要为8岁以下患儿;不同季节ARTI患者病毒阳性检出率差异有统计学意义(χ^(2)=27.291,P<0.05);PIV1、PIV2、ADV和混合感染检出率的季节分布差异无统计学意义(P>0.05);PIV3阳性检出率最高为春季(4.04%),RSV在春季和冬季的阳性检出率分别为(24.24%)和(25.20%);甲型流感病毒和乙型流感病毒阳性检出率最高在冬季(9.45%)和(7.09%);不同临床诊断ARTI患者病毒阳性检出率差异有统计学意义(χ^(2)=17.452,P<0.05);PIV2、PIV3、甲型流感病毒和乙型流感病毒阳性检出率差异有统计学意义(P<0.05);支气管肺炎病毒阳性检出率最高(27.48%)。结论急性呼吸道病毒感染患者以RSV感染最为常见,多发生在秋冬季,其中主要临床表现为支气管肺炎,主要感染人群为8岁以下患儿,今后应加强对呼吸道合胞病毒的监测。

Objective To understand the epidemiological characteristics of acute respiratory virus infection in hospitalized patients,and to provide reference for clinical diagnosis and treatment,and to develop relevant intervention measures.Methods A total of 414 hospitalized patients with respiratory virus infection admitted to our hospital from March 2019 to March 2021 were selected.Immunofluorescence method was used to qualitative detect parainfluenza virus type 1-3,influenza A virus,respiratory syncytial virus(RSV),influenza B virus and adenovirus.Results Among the 414 ARTI patients,84 cases were positive for respiratory virus,with a positive detection rate of 20.29%(84/414).76 cases were positive for single virus infection,with a positive detection rate of 18.36%(76/414).The positive detection rate was 1.93%(8/414).The most common pathogens of virus infection were influenza A virus(25.00%),influenza B virus(20.23%)and RSV(17.86%).There was statistical significance in the positive rate of ARTI among different age groups(χ^(2)=84.692,P<0.05).The positive rate of respiratory virus in 1-8 years group was the highest(38.93%).There was statistical significance in the positive rate of 7 viruses(P<0.05).The patients with viral mixed infection were mainly children under 8 years old;There was statistical significance in the positive rate of ARTI in different seasons(χ^(2)=27.291,P<0.05).There was no significant difference in the seasonal distribution of PIV1,PIV2,ADV and mixed infection rates(P>0.05).The positive rate of PIV3 was the highest in spring(4.04%),and the positive rate of RSV in spring and winter was 24.24%and 25.20%,respectively.The positive rates of influenza A virus and influenza B virus were the highest in winter(9.45%)and(7.09%).There was statistical significance in the positive rate of ARTI among different clinical diagnoses(χ^(2)=17.452,P<0.05).The positive rates of PIV2,PIV3,influenza A virus and influenza B virus were significantly different(P<0.05).The positive rate of bronchopneumonia virus was the highest(27.48%).Conclusion RSV infection is the most common in patients with acute respiratory virus infection in Chengdu area,which mostly occurs in autumn and winter,and the main clinical manifestation is bronchopneumonia.The main infected population is children under 8 years old,and the surveillance of respiratory syncytial virus should be strengthened in the future.