兰州市2009-2013年住院病例中严重急性呼吸道感染病毒病原学监测研究

Viral etiology and clinical features of severe acute respiratory infection(SARI)among hospitalized patients in Lanzhou city of China from 2009 to 2013

目的了解兰州市住院病例中严重急性呼吸道感染(severe acute respiratory infection,SARI)住院病例的病毒病原学构成、季节分布和临床特征,为兰州市SARI病例的临床诊断治疗及防控提供线索和依据。方法对2009年12月至2013年12月在兰州大学第一医院内科急诊病房、呼吸科、儿科及ICU病房住院治疗的804例SARI病例采集鼻咽拭子进行病毒核酸检测,同时收集病例的临床特征等相关信息。结果4年共检测804份病例咽拭子,病毒阳性病例328例,检出率为40.80%,其中流感病毒(Flu)阳性率14.18%、呼吸道合胞病毒(respiratory syncytial virus,RSV)阳性率12.06%、腺病毒阳性率2.98%、副流感病毒Ⅰ~Ⅲ型阳性率7.12%,鼻病毒(HRV)阳性率7.84%,4种非SARS冠状病毒(COV)阳性率4.10%,偏肺病毒(HMPV)阳性率1.99%,博卡病毒(BoCA)阳性率0.87%,肠道病毒(EV)阳性率0.62%。结论兰州市SARI住院患者病毒检出率最高的是流感病毒和RSV,病毒感染可能是加重SARI病例临床症状的原因之一;不同病毒感染所致疾病特征有所差异,流感病毒以上呼吸道感染为主,RSV以支气管肺炎为主。

Objective To identify the respiratory viruses and related clinical characteristics in hospitalized patients with acute lower respiratory tract infection(ALRI)in Lanzhou city of China. Methods Clinical and demographic information and throat swabs were collected from 804 patients from December 1st,2009 to December 31 st,2013.Multiplex RT-PCR was performed to detect 15 common respiratory viral pathogens. Results A total of 804 patients were admitted as ALRIs with ages from 1 month to 90years;484(60.20%,N=804)were male(M/F ratio=1.51).Of which,328(40.80%)were positive for at least one pathogen.A total of 417 respiratory viral pathogens were identified from the 328 patients.Respiratory syncytial virus(RSV)was the most frequently detected pathogen(97/417,23.26%),followed by Influenza A(Flu A)(82/417,19.66%),human rhinovirus(HRV)(63/417,15.11%),parainfluenza virus(PIV)1-3(58/417,13.91%),human coronavirus(CoV)(33/417,7.91%),Flu B(32/417,7.67%),human adenovirus(HAdV)(24/417,5.76%);human metapneumovirus(hMPV),enterovirus and human bocavirus(BoCA)were 3.84%,1.68% and 1.20%,respectively. Conclusions RSV,Flu A/B were the most common pathogens in patients under 4years old and showed seasonal variation with peaks during winter and spring.