儿童呼吸道病毒感染病原学特征分析

Pathogenic characteristics of respiratory tract infection virus in children

目的分析河南南阳地区儿童呼吸道病毒感染的病原学特征。方法回顾南阳市中心医院患儿的性别、年龄、入院时间、临床症状、病原学检测结果等病史,分析不同呼吸道疾病的病毒检出情况。采集患儿鼻咽抽吸物,进行标本处理、核酸提取、逆转录,采用巢式PCR检测呼吸道合胞病毒、副流感病毒、人博卡病毒、偏肺病毒,采用荧光定量PCR检测流感病毒、人鼻病毒、人肠道病毒,采用单轮PCR方法检测人腺病毒、人冠状病毒。结果1156例标本中,542例检出呼吸道病毒,阳性率为46.89%,32.79%为单一感染,14.10%为两种病毒混合感染。单一病毒感染患儿中,27.44%为呼吸道合胞病毒感染,占比最高。混合感染中,23.31%为呼吸道合胞病毒+副流感病毒混合感染,占比最高。对比每种病毒单一感染与混合感染的阳性率,副流感病毒在混合感染中的检出率高于单一感染,人腺病毒、人鼻病毒、人博卡病毒、人肠道病毒、偏肺病毒、人冠状病毒在单一感染中的检出率高于混合感染。1156例患儿中,肺炎565例,上呼吸道感染295例,哮喘158例,急性支气管炎72例,喘息性支气管炎35例,毛细支气管炎31例。其中肺炎患儿病毒检出率最高为66.55%(376/565),不同疾病分组病毒检出率差异有统计学意义(χ^(2)=202.132,P<0.05)。163例混合感染中,春季71例,夏季17例,秋季28例,冬季47例。新生儿组79例,婴儿组43例,幼儿组28例,儿童组13例。呼吸道合胞病毒单一感染患儿中,52.88%患儿为呼吸道合胞病毒A型阳性,47.12%患儿为呼吸道合胞病毒B型阳性,呼吸道合胞病毒A型阳性组主要以男性为主,两组对比差异具有统计学意义。结论本地区儿童呼吸道感染病毒主要为呼吸道合胞病毒,不同疾病分组病毒检出率不同,混合感染多发生于春季与新生儿组,呼吸道合胞病毒A型感染男性占比较高。

Objective To analyze the pathogenic characteristics of respiratory tract infection virus in children.Methods The sex,age,time of admission,clinical symptoms,pathogenic test results and other medical history of the children were retrospectively analyzed,and the virus detection of different respiratory diseases was analyzed.Nasopharyngeal aspirates from children were collected for sample processing,nucleic acid extraction and reverse transcription.RSV,PIV,HBoV and MPV were detected by nested PCR,IFV,HRV,HEV were detected by fluorescent quantitative PCR,and HAdV,HCoV were detected by single round PCR.Results Among 1156 samples,the positive rate was 46.89%,32.79%was single infection,and 14.10%was mixed infection of two viruses.Among children with single virus infection,27.44%were RSV,infection,accounting for the highest proportion.Among the mixed infections,23.31%were RSV+PIV,accounting for the highest proportion.Comparing the positive rates of single infection and mixed infection of each virus,the detection rate of PIV in mixed infection is higher than that in single infection,and the detection rate of HAdV,HRV,HBoV,HEV,MPV and HCoV in single infection is higher than that in mixed infection.Among the children in this study,there were 295 cases of upper respiratory tract infection,565 cases of pneumonia,158 cases of asthma,72 cases of acute bronchitis,35 cases of asthmatic bronchitis and 31 cases of bronchiolitis.Among them,the highest detection rate of pneumonia was 66.55%,and the detection rate of virus in different disease groups was statistically significant(P<0.05).Among 163 cases of mixed infection,71 cases were in spring,17 cases in summer,28 cases in autumn and 47 cases in winter.There were 79 newborns,43 infants,28 infants and 13 children.Among children with single infection of RSV,52.88%were positive for RSV type A,and 47.12%were positive for RSV type B.the positive group of RSV type A was mainly male,and the difference between the two groups was statistically significant(P<0.05).Conclusion Respiratory tract infection virus in children in this area is mainly RSV,and the detection rate of virus in different disease groups is statistically significant.Mixed infection mostly occurs in spring and neonatal group,and men account for a higher proportion in the positive group of RSV type A infection.