2015~2019年云浮人民医院住院儿童呼吸道合胞病毒感染的特点分析

Features of respiratory syncytial virus infection of hospitalized children in Yunfu People’s Hospital from 2015 to 2019

目的 调查 2015~2019 年云浮人民医院住院儿童呼吸道合胞病毒 (RSV) 感染的特点。 方法 收集云浮人民医院儿科 2015~2019 年住院的、采集鼻咽拭子用直接免疫荧光法检测过呼吸道七项病毒的 6650 例急性呼吸道感染患儿的临床资料 , 分析并比较不同年龄段患儿的 RSV 阳性率 , 不同性别患儿的 RSV 阳性率 , 各年份的 RSV 阳性率 , 不同疾病患儿的 RSV 阳性率 , 2015~2019 年每个年度内各月份 RSV 阳性率。结果 6650 例患儿中 RSV 阳性 791 例 , 阳性率为 11.89%;1 月龄 ~14 岁患儿均有 RSV 阳性检出 , 且患儿年龄越大 , RSV 阳性检出率越低 , 不同年龄段患儿 RSV 阳性率比较差异有统计学意义 (χ^(2)=421.942, P=0.000<0.05)。4301 例男性患儿中 RSV 阳性 528 例 , 2349 例女性患儿中RSV 阳性 263 例 , 不同性别患儿的 RSV 阳性率比较差异无统计学意义 (χ^(2)=1.691, P=0.193>0.05)。2015~2019 年的每年 RSV 阳性率比较差异无统计学意义 (χ^(2) =6.132, P=0.190>0.05)。RSV 引起的呼吸道感染疾病中主要是下呼吸道感染 , 其中 , 支气管肺炎患儿的 RSV 阳性率最高 , 为 21.07%(679/3223);其次是急性支气管炎 , 为 8.45%(93/1101);各种疾病的 RSV 阳性率比较差异具有统计学意义 (χ^(2)=543.960,P=0.000<0.05)。2015~2019 年每个年度内各月份 RSV 阳性率比较差异均有统计学意义 (P<0.05)。每年RSV 有 2 个感染高峰期 , 多集中在 1 月份和 12 月份 , 不同年份有所差别 , 2015、2017、2019 年 1 月份均为感染最高峰 , 2015、2019 年第二高峰在 12 月份 , 2017 年第二高峰在 9 月份;2016 年感染最高峰在12 月份 , 第二高峰在 1 月份;2018 年感染最高峰在 8 月份 , 其次在 6 月份 , 1 月份和 12 月份阳性率最低。结论 RSV 是云浮人民医院住院儿童呼吸道感染重要的病毒 , 有明显流行季节 , 感染人群集中在 <3 岁儿童 , <1 岁儿童的感染率最高 , 容易导致下呼吸道感染。

Objective To investigate the features of respiratory syncytial virus (RSV) infection of hospitalized children in Yunfu People’s Hospital from 2015 to 2019. Methods 6650 children with acute respiratory tract infection were hospitalized in the Department of Pediatrics of Yunfu people’s Hospital from 2015 to 2019. Their nasopharyngeal swabs were collected and detected for seven respiratory viruses with the direct immunofluorescence method. Their clinical data was collected and analyzed. The RSV positive rates in children of different ages, different gender, hospitalized in different years, with different diseases, and the RSV positive rates of each month in each year from 2015 to 2019 were compared. Results Among 6650 children, 791 were RSV positive, with a positive rate of 11.89%;all children aged from 1 month to 14 years were RSV positive;and the older the children were, the lower the RSV positive rate was. The difference in RSV positive rate among children of different ages was statistically significant (χ^(2)=421.942, P=0.000<0.05). There were 528 RSV positive cases in 4301 male children and 263 RSV positive cases in 2349 female children, and difference in RSV positive rates between children of different gender was not statistically significant (χ^(2)=1.691, P=0.193>0.05). The difference in RSV positive rate in each year from 2015 to 2019 was not statistically significant (χ^(2)=6.132, P=0.190>0.05).Among the respiratory tract infections caused by RSV, the lower respiratory tract infection was the major one,where the children with bronchopneumonia had the highest RSV positive rate, which was 21.07% (679/3223);the children with acute bronchitis had the second highest RSV positive rate, which was 8.45% (93/1101);and the differences in RSV positive rates among various diseases were statistically significant (χ^(2)=543.960, P=0.000<0.05).The differences in RSV positive rates in each month of each year from 2015 to 2019 were statistically significant(P<0.05). There were two RSV infection peaks each year, which appeared mostly in January and December,varying from year to year. The highest RSV infection peak appeared in January in the years of 2015, 2017 and 2019, and the second highest RSV infection peak appeared in December in the years of 2015 and 2019, and in September in 2017;in 2016, the highest RSV infection peak appeared in December, and the second highest peak appeared in January;in 2018, the highest RSV infection peak appeared in August, and the second highest peak appeared in June, while the lowest RSV infection rate appeared in January and December. Conclusion RSV is an important virus in respiratory tract infection in the hospitalized children in Yunfu People’s Hospital, which has an obvious epidemic season. The infected population is mainly children under 3 years old, and the highest infection rate appears in children under 1 year old, which easily leads to the lower respiratory tract infection.