2014-2017年北京市怀柔区急性呼吸道病毒感染病例流行病学分析

Etiological and epidemiological analysis of acute respiratory viral infections in Huairou district of Beijing during 2014-2017

目的了解怀柔地区呼吸道病毒感染的病原学和流行病学特征,为临床诊断和治疗提供参考。方法选取2014年8月至2017年12月北京怀柔医院就诊的门诊或住院呼吸道感染患者的咽拭子,应用实时荧光PCR方法对8种呼吸道病毒(包括亚型共14种)进行检测和分析。结果对911份样本进行检测,检出阳性样本244例,阳性率26.78%;病毒感染率前五位的依次为季节性甲型H3N2流感病毒71份(7.79%)、乙型流感病毒34份(3.73%)、副流感病毒31份(3.40%)、鼻病毒25份(2.74%)、呼吸道合胞病毒23份(2.52%)。≤14岁儿童中呼吸道病毒阳性检出率较高,其中2~岁组阳性率最高,为35.66%,不同年龄组人群呼吸道病毒检出率差异有统计学意义(χ~2=21.31,P=0.00)。不同季节吸道病毒检出率不同(χ~2=43.96,P<0.01),冬季最高(42.41%),其次是春季和秋季。流感病毒、RSV和人偏肺病毒感染主要发生在每年的冬春季,PIV感染主要发生在夏秋季。呼吸道病毒在上呼吸道感染病例(31.76%)中的检出率高于下呼吸道感染病例(24.71%)(χ~2=4.44,P=0.04)。结论 14岁及以下儿童呼吸道病毒感染率较高,是防控的重点人群;呼吸道病毒感染呈现一定的季节性特征,冬春季高发。

Objective To understand the epidemiological and etiological characteristics of acute respiratory viral infections in Huairou district of Beijing.Methods Nasopharyngeal swabs were collected from outpatients and inpatients with respiratory infections in Beijing Huairou hospitals from August 2014 to December 2017.Real-time PCR was applied to detect 8 types of respiratory viruses(14 subtypes).Results A total of 911 samples were collected and tested,244 samples were positive with the positive rate of 26.78%.The top five common viruses identified were FluA(H3 N2)(7.79%,71/911),FluB(3.73%,34/911),PIV(3.40%,31/911),RV(2.74%,25/911)and RSV(2.52%,23/911).The positive rate of respiratory viruses varied significantly among subjects in different age group(χ~2=21.31,P=0.00)with the highest of 35.66%in children of 2-4 years old.It also varied significantly in different season(χ~22=43.96,P<0.01)with the highest of 42.41%in winter.Cases with influenza virus,RSV and hMPV infections mainly appeared in winter and spring,while those with PIV infection usually appeared in summer and autumn.The positive rate of respiratory viruses in patients of upper airway infection was higher than that in patients of lower airway infection(31.76%vs 24.71%;χ~2=4.44,P=0.04).Conclusions Children under 15 years old are more susceptible to respiratory viruses with higher infection rate.The incidence of respiratory viral infection is higher in winter and spring.