儿童呼吸道腺病毒感染的影响因素与病毒亚型

Influencing factors for respiratory tract adenovirus infection in children and subtypes of adenovirus

目的 探讨呼吸道感染儿童腺病毒(ADV)感染的影响因素与病毒亚型.方法 回顾性分析2019年2月-2022年3月内蒙古自治区人民医院收治的120例呼吸道ADV感染患儿的临床资料,分析其流行病学特征及病毒基因亚型分布;随后选取同时于医院住院治疗的85例呼吸道感染患儿(无ADV感染)纳入对照组,分析呼吸道感染患儿ADV感染的影响因素.结果 年龄3岁以下呼吸道ADV感染者阳性率为55.00%,高于其他年龄阶段的儿童(P<0.001);春冬季出现呼吸道ADV感染者阳性率为78.33%高于夏季、秋季(P<0.001);家庭月收入在3 000元以下的家庭,儿童出现呼吸道ADV感染者阳性率为66.67%,高于3 000元以上的家庭(P<0.001);居住地在城市的儿童出现呼吸道ADV感染者阳性率为81.67%,高于农村居住的儿童(P<0.001);咳嗽、流清涕、发热、咽部充血是呼吸道ADV感染儿童最主要的临床表现,主要经空气传播,多数患儿表现为单一感染;120例患儿病毒亚型中包括78例B亚型,占65.00%;39例C亚型,占32.50%;3例D亚型,占2.50%;其中主要致病ADV亚型为3型ADV、7型ADV,分别占18.33%、46.67%;Logistic回归分析发现年龄、居住地、季节、免疫功能低下、反复肺部感染、先天性气道发育异常是呼吸道ADV感染的影响因素(P<0.05).结论 呼吸道ADV感染多发于年龄在3岁以下、低收入家庭、城区儿童,且春冬季为高发季节,患儿主要表现为咳嗽、流清涕、发热、咽部充血,经空气传播,且多表现为单一传播,病原菌分析发现3型ADV、7型ADV为主要致病菌;年龄、居住地、季节、免疫功能低下、反复肺部感染、先天性气道发育异常是影响呼吸道ADV感染的影响因素.

OBJECTIVE To investigate the influencing factors of adenovirus infection in children with respiratory tract infections and viral subtypes.METHODS The clinical data of 120 children with respiratory ADV infection who were admitted to Inner Mongolia People's Hospital from Feb.2019 to Mar.2022 were retrospectively analyzed.The subjects'epidemiological characteristics and ADV subtype distribution were analyzed.Subsequently,85 children with respiratory infection(without ADV infection)who were also hospitalized in the hospital during the same period were selected and included in the control group,and the influencing factors of ADV infection in children with respiratory tract infection were analyzed.RESULTS The positive rate of respiratory ADV infection among children under 3 years old was 55.00%,higher than that in the other age groups(P<0.001).The positive rate of respiratory ADV infection in spring and winter was 78.33%,higher than that in summer and autumn(P<O.oo1).The positive rate of respiratory ADV infection in children from families with family monthly income less than 3000 yuan was 66.67%,higher than that in families with more than 3000 yuan(P<0.001).The positive rate of respiratory ADV infection in children living in urban areas was 81.67%,higher than that in children living in rural areas(P<0.001).Cough,runny nose,fever,and pharyngeal hyperaemia were the main clinical manifestations of children with respiratory ADV infection,mainly through airborne transmission,and most children presented with a single infection.Among the virus subtypes inl20 children with ADV infection,there were 78 children infected with subtype B,accounting for 65.00%,39 children infected with subtype C,accounting for 32.50%,and 3 children infected with subtype D,accounting for 2.50%.The main pathogenic ADV subtypes were type 3 ADV and type 7 ADV,accounting for 18.33%and 46.67%,respectively.Logistic regression analysis found that age,residence,season,immunocompromised,repeated pulmonary infection,and congenital airway dysplasia were influential factors of respiratory ADV infection(P<0.05).CONCLUSION Respiratory ADV infection were mostly seen in children under 3 years old,those from low-income families,and those living in city,with a high incidence in spring and winter.Children mainly presented with cough,clear runny nose,fever,and pharyngeal hyperaemia,which were airborne and tend to present as single transmission.Analysis of the pathogenic organisms identified ADV type 3 and ADV type 7 as the main causative agents.In addition,age,place of residence,season,immune deficiency,recurrent pulmonary infections,and congenital airway dysplasia were the influential factors affecting respiratory ADV infection.