长沙地区急性下呼吸道感染住院儿童的病毒病原学分析

Viral etiology of Changsha hospitalized children with acute lower respiratory tract infection

目的 :了解长沙地区急性下呼吸道感染(ALRTI)住院儿童中常见呼吸道病毒的流行特点,为本地区儿童ALRTI的防治提供依据。方法 :收集2013年4月~2014年3月诊断为ALRTI的住院患儿鼻咽抽吸物(NPA)标本603份,采用实时荧光PCR方法检测呼吸道合胞病毒(RSV)、鼻病毒(HRV)、流感病毒A(IFVA)、流感病毒B(IFVB)、副流感病1-4(PIV1-4)、人偏肺病毒(h MPV)、肠道病毒(EV)、冠状病毒HKU1(HCo V-HKU1)、冠状病毒NL63(HCo V-NL63)、腺病毒(ADV)及人博卡病毒(HBo V),结合临床资料进行统计分析。结果 :603份标本中有527份检出病毒,总检出率87.4%,RSV检出率居首位为42.6%,其次HRV为25.4%、HBo V为17.7%、PIV3为15.4%,ADV为14.76%。病毒总检出率在男女之间差异无统计学意义;病毒阳性检出率在各年龄段之间差异有统计学意义,以6个月至1岁以内年龄段检出率最高。病毒总检出率季节分布差异有统计学意义,以冬季检出率最高。结论:病毒病原在长沙地区儿童ALRTI中占重要地位,其中RSV、HRV、HBo V、PIV3、ADV是常见病毒病原,易感人群以低年龄段儿童为主,冬春季为高发季节。

Objective To explore the epidemic characteristics of common respiratory viruses among hospitalized children of acute low respiratory tract infection(ALRTI) in Changsha of Hunan Province of China,provide the basis for prevention and control of the region’s children with ALRTI. Methods Nasopharyngeal aspirates(NPA) were collected from 603 hospitalized children with ALRTI in Changsha from April 2013 to March 2014.Respiratory syncytial virus(RSV), human rhinovirus(HRV),influenza virus A(IFVA),influenza virus B(IFVB), parainfluenza 1-4(PIV1-4),human metapneumovirus(h MPV), enterovirus(EV), human coronaviruses HKU1(HCo V-HKU1), human coronaviruses NL63(HCo V-NL63), adenovirus(ADV) and human bocavirus(HBo V) were detected by real-time fluorescence polymerase chain reaction(RT-PCR),then combined with clinical data and through statistical analysis. Results Among the 603 NPA,viruses were detected in 527 samples(87.4%),among which RSV(42.6%) was the most common virus,followed by HRV(25.4%), HBo V(17.7%), PIV3(15.4%) and ADV(14.76%). The overall positive rate of viral detection showed no significant differences between males and females.The positive rate of viral detection showed significant differences among different age sections(χ2=43.041, P=0.000), and the highest positive rate was noted in the age section of 6 months to 1 year old.Furthermore,the overall positive rate of viral detection showed a significant difference in term of seasonal distribution(χ2=13.864, P=0.003), with a peak prevalence in winter. Conclusion Virues predominate in the etiology of pediatric ALRTI in Changsha,and RSV, HRV, HBo V, PIV3 and ADV are the main viruses for ALRTI.Viral infection-associated ALRTI shows a prevail in the low age group as well as in winter and spring.