[2007年至2010年儿童急性下呼吸道感染病毒病因的三年监测]

[Three years surveillance of viral etiology of acute lower respiratory tract infection in children from 2007 to 2010].

作者信息

Xie Zheng-de, Xiao Yan, Liu Chun-yan, Hu Ying-hui, Yao Yuan, Yang Yan, Qian Su-yun, Geng Rong, Wang Jian-wei, Shen Kun-ling

机构信息

Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics (Capital Medical University), Ministry of Education, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.

出版信息

Zhonghua Er Ke Za Zhi. 2011 Oct;49(10):745-9.

PMID:22321179

Abstract

OBJECTIVE

Viruses are common pathogens of acute lower respiratory tract infection (ALRTI) in children. There are few studies on consecutive monitoring of viral pathogens of ALRTI in a larger cohort during the past several years. The aim of this study was to investigate the viral pathogens of ALRTI in children of different age groups and to outline the epidemic feature of different viruses.

METHOD

(1) Totally 1914 (1281 male and 709 female) children with clinical diagnosis of ALRTI during the period of March 2007 to March 2010 were recruited into this study. These patients were hospitalized patients in department of internal medicine or outpatients in emergency department in Beijing Children's Hospital. The patients were divided into four groups, including 1072 patients < 1 year old, 326 patients 1- < 3 years old, 158 patients 3- < 6 years old, 358 patients ≥ 6 years old. One nasopharyngeal aspirate specimen was collected from each patient. Reverse transcription (RT) PCR methods were applied to detect common respiratory viruses including respiratory syncytial virus (RSV), human rhinovirus (HRV), influenza virus type A, B and C (IFA, IFB, IFC), parainfluenza virus (PIV) type 1-4, adenovirus (ADV), enterovirus (EV), human coronavirus (HCOV), human metapneumovirus (HMPV) and human bocavirus (HBOV).

RESULT

(1) The total positive rate of viruses was 70.3%. The positive rate was 83.0% (890/1072) in the group of < 1 year old, and 80.1% (261/326) in group of 1- < 3 years old, 60.8% (96/158) in group of 3- < 6 years old and 27.7% (99/358) in group of ≥ 6 years old, respectively. There was a significant difference in the positive rate among different age groups (χ² = 2213.5, P = 0.000). The top three viruses were RSV, HRV and PIV; and the positive rates were 50.9%, 36.2% and 12.0% respectively in group of < 1 year old. (2) The epidemic seasons of RSV and HRV were winter and spring, and PIV infection was epidemic in spring and summer. (3) The detection rates of 2 or more viruses were 38.2%, 36.4%, 30.2% and 15.2% in groups of < 1 year old, 1- < 3 years old, 3- < 6 years old and ≥ 6 years old, respectively. There was a significant difference in the mixed infection rate among different age groups (χ² = 1346.00, P = 0.000).

CONCLUSION

RSV, HRV and PIV were the most predominant pathogens in younger children with ALRTI. Different viral infections had different seasonal features. Mixed infections with two or more viruses were detected in substantial proportion of patients with ALRTI, but further studies are needed to explore the clinical significance of mixed infection with viruses in patients with ALRTI.

摘要

目的

病毒是儿童急性下呼吸道感染（ALRTI）的常见病原体。在过去几年中，针对较大队列的ALRTI病毒病原体进行连续监测的研究较少。本研究旨在调查不同年龄组儿童ALRTI的病毒病原体，并概述不同病毒的流行特征。

方法

（1）选取2007年3月至2010年3月期间临床诊断为ALRTI的1914例儿童（男1281例，女709例）纳入本研究。这些患者为北京儿童医院内科住院患者或急诊科门诊患者。将患者分为四组，包括1072例＜1岁患儿、326例1～＜3岁患儿、158例3～＜6岁患儿、358例≥6岁患儿。为每位患者采集一份鼻咽抽吸物标本。采用逆转录（RT）PCR方法检测常见呼吸道病毒，包括呼吸道合胞病毒（RSV）、人鼻病毒（HRV）、甲型、乙型和丙型流感病毒（IFA、IFB、IFC）、1～4型副流感病毒（PIV）、腺病毒（ADV）、肠道病毒（EV）、人冠状病毒（HCOV）、人偏肺病毒（HMPV）和人博卡病毒（HBOV）。

结果

（1）病毒总阳性率为70.3%。＜1岁组阳性率为83.0%（890/1072），1～＜3岁组为80.1%（261/326），3～＜6岁组为60.8%（96/158），≥6岁组为27.7%（99/358）。不同年龄组阳性率差异有统计学意义（χ²=2213.5，P=0.000）。前三位病毒为RSV、HRV和PIV；＜1岁组阳性率分别为50.9%、36.2%和12.0%。（2）RSV和HRV的流行季节为冬春季节，PIV感染在春夏季节流行。（3）＜1岁组、1～＜3岁组、3～＜6岁组和≥岁组两种或以上病毒的检出率分别为38.2%、36.4%、30.2%和15.2%。不同年龄组混合感染率差异有统计学意义（χ²=1346.00，P=0.000）。