[苏州住院儿童急性呼吸道感染的病因学研究]

[An etiological study on acute respiratory infection among inpatient children in Suzhou].

作者信息

Ji Wei, Wu Jun-hua, Huang Lu, Luo Ya-li, Zhang Xue-lan

机构信息

Department of Respiration, Children's Hospital Affiliated to Soochow University, Suzhou, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2009 Oct;43(10):867-71.

PMID:20137465

Abstract

OBJECTIVE

To investigate the pathogen of children with acute respiratory infection (ARI) in Suzhou and to provide some evidences for clinical diagnosis and treatment.

METHODS

The nasopharyngeal secretion samples from 2492 inpatient children with ARI, during the period of November 2005 to May 2007, were investigated for respiratory syncycial virus (RSV), influenza virus A and B, parainfluenza virus type 1, 2, 3 and adenovirus by both the indirect immunofluorescence assay and virus isolation. Human metapneumovirus (hMPV) were examined by reverse-transcription polymerase chain reaction (RT-PCR) at the same time.

RESULTS

Of 2492 samples tested, 961 (38.6%) were positive. The total positive rate of virus pathogens in children with ARI was found related to age, season and respiratory disease. The detection rates by age were: 50.0% (412/824), 43.4% (190/438), 30.5% (207/679)and 27.6% (152/551), chi(2) = 96.5002, P < 0.01; the detection rates by season were : 46.7% (366/784), 13.8% (66/478), 13.8% (59/428) and 58.6% (470/802), chi(2) = 392.3279, P < 0.01; the detection rates by disease were (acute upper respiratory infection, acute laryngitis, throat-trachea-bronchitis, bronchial pneumonia, pneumonia genuine, bronchiolitis, bronchial asthma): 21.4% (30/140), 73.7% (14/19), 32.0% (8/25), 36.9% (598/1620), 13.1% (8/61), 66.1% (216/327) and 29.0% (87/300), chi(2) = 162.1276, P < 0.01. There was no association between the total positive rate and sex. The detection rates by sex were: 39.0% (588/1508) for male and 37.9% (373/984) for female, chi(2) = 0.2962, P > 0.05. The peak of RSV appeared from December to March. There was the highest RSV detection rate 50.2% (164/327) with bronchiolitis. The hMPV can be detected all year around. The peak of hMPV appeared in winter and the detection rate was 13.2% (106/802).

CONCLUSION

RSV and hMPV are the main respiratory viral pathogens in Suzhou. Detection of viral pathogens in children with respiratory infection could give fast, accurate diagnostic evidence, and help avoid antibiotics abuse.

摘要

目的

调查苏州地区急性呼吸道感染（ARI）患儿的病原体，为临床诊断和治疗提供依据。

方法

选取2005年11月至2007年5月期间2492例ARI住院患儿的鼻咽分泌物样本，采用间接免疫荧光法和病毒分离法检测呼吸道合胞病毒（RSV）、甲型和乙型流感病毒、1、2、3型副流感病毒及腺病毒。同时采用逆转录聚合酶链反应（RT-PCR）检测人偏肺病毒（hMPV）。

结果

2492份样本中，961份（38.6%）呈阳性。ARI患儿病毒病原体总阳性率与年龄、季节及呼吸道疾病有关。按年龄分组的检出率分别为：50.0%（412/824）、43.4%（190/438）、30.5%（207/679）和27.6%（152/551），χ² = 96.5002，P < 0.01；按季节分组的检出率分别为：46.7%（366/784）、13.8%（66/478）、13.8%（59/428）和58.6%（470/802），χ² = 392.3279，P < 0.01；按疾病分组的检出率分别为（急性上呼吸道感染、急性喉炎、喉气管支气管炎、支气管肺炎、真性肺炎、细支气管炎、支气管哮喘）：21.4%（30/140）、73.7%（14/19）、32.0%（8/25）、36.9%（598/1620）、13.1%（8/61）、66.1%（216/327）和29.0%（87/300），χ² = 162.1276，P < 0.01。总阳性率与性别无关。男性检出率为39.0%（588/1508），女性为37.9%（373/984），χ² = 0.2962，P > 0.05。RSV高峰出现在12月至次年3月。细支气管炎患儿RSV检出率最高，为50.2%（164/327）。hMPV全年均可检出，冬季出现高峰，检出率为13.2%（106/802）。