老年住院患者呼吸道常见病毒感染临床观察  

Clinical study on common respiratory tract virus infection in elderly hospitalized patients

作　　者：张方[1] 王嘉祺[2] 马慧[1] 杜玲玲[2] 邹凤梅[3] 刘刚[3] 魏莲花[3] 

机构地区：[1]甘肃省人民医院呼吸科,兰州730000 [2]甘肃省人民医院干部病房呼吸科,兰州730000 [3]甘肃省临床检验中心

出　　处：《中国综合临床》2007年第5期407-409,共3页Clinical Medicine of China

基　　金：甘肃省科学事业费重点科研基金项目（QS041-C33-21）

摘　　要：目的了解冬、春季节兰州地区因急性呼吸道感染住院的老年患者常见病毒感染状况。方法对兰州地区3所三级甲等医院呼吸科年龄65岁或以上的318例因急性呼吸道感染而住院治疗的老年患者，通过间接酶联免疫吸附实验（ELISA，定量法）检测血清中病毒特异性IgM抗体，包括流感病毒A（Flu A）、流感病毒B（Flu B）、呼吸道合胞病毒（RSV）、腺病毒（ADV）、副流感病毒（PIV）。结果318例患者中有112例被检测到1、2种或2种以上病毒特异性IgM抗体阳性。其中Flu A77例（24．2％），Flu B41例（12．9％），RSV 32例（10．1％）；ADV和PIV的检出率较低，分别是4．1％（13／318）和1．3％（4／318）。少数患者（35／318，11．0％）存在2种或2种以上病毒感染；其中FluA和FluB、FluA和RSV混合感染多见，有26例（26／318，8．2％）；有9例（9／318，2．8％）FluA、FluB、RSV三种混合感染。其中112例病毒检测阳性患者中有19例（16．9％）同时培养出致病细菌，112例中74例（66．1％）有基础疾病。结论FluA是兰州地区冬、春季节老年人急性呼吸道感染住院患者最多见的病毒病原体，FluB和RSV次之，ADV和PIV感染少见。存在2种或2种以上病毒感染情况，有基础疾病老年患者感染呼吸道病毒的风险增加，合并细菌混合感染者增多。Objective To study the common virus infection of elderly hospitalized patients admitted because of acute respiratory tract infections during winter and spring in Lanzhou district. Methods The virus serum specific IgM antibodies of 318 elderly patients（ ≥65 years） in three Class-A hospitals were detected by the indirect enzyme linked immunosorbent assay （ ELISA ）, including influenza virus A （ FluA ）, influenza virus B （ FluB ）, respiratory syncytial virus （ RSV ）, aderovirus （ ADV ） and parainfluenza virus （PIV）. Results 112 of 318 cases were viral IgM antibody positive,among whom FluA was detected in 77 cases （24.2%） ,Flu B in 41 （ 12.9% ） and RSV in 32（ 10.1% ） ; ADV was detected inl3 （13/318,4.1%） and PIV in 4（4/318,1.3% ）. 35 cases （35/318,11.0%） were tested with infection of two or more kinds of viruses, among whom FluA ＋ FluB and FluA ＋ RSV were detected in 26 cases（8.2% ）. FluA ＋ FluB ＋ RSV was seldom seen only in 9 csaes （9/318,2.8%）. 19 cases （ 19/112, 16.9% ） with virus IgM antibody positive were also infected with disease-causing bacteria and 74 cases （ 74/112,66. 1% ）had basic diseases. Conclusion FluA is the most popular virus which causes the elderly peoples respiratory tract infections in Lanzhou district during winter and spring,followed by FluB and RSV while the infection of ADV and PIV is seldom seen. The elderly patients who have basic diseases and two or more virus infection have more risks to be infected with the respiratory tract virus and complicated wtih bacteria infection.

关 键 词：呼吸道感染 老年人 病毒感染 

分 类 号：R5[医药卫生—内科学]