2003-2007年重庆地区急性下呼吸道感染患儿病毒监测情况  

Surveillance for Respiratory Viruses in Children with Acute Lower Respiratory Infections in Chongqing between 2003 and 2007

作　　者：彭东红[1] 刘恩梅[1] 赵晓东[2] 黄英[1] 刘瑜[3] 罗晓菊[4] 

机构地区：[1]重庆医科大学附属儿童医院呼吸中心 [2]重庆医科大学附属儿童医院肾脏免疫科 [3]重庆医科大学附属儿童医院儿科研究所病毒室 [4]重庆医科大学附属儿童医院儿科研究所免疫室

出　　处：《实用儿科临床杂志》2009年第10期768-770,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的分析重庆地区急性下呼吸道感染(ALRI)患儿2003-2007年病毒病原学构成及变化情况,探讨鼻咽分泌物(NPS)病毒抗原检测与血清病毒抗体检测对ALRI患儿病原学诊断的价值。方法2003年4月-2007年10月从2529例ALRI住院患儿吸取了NPS标本,采用免疫荧光法检测7种常见的呼吸道病毒抗原:呼吸道合胞病毒(RSV)、腺病毒(ADV)、A型流感病毒(IA)、B型流感病毒(IB)、副流感病毒1、2、3型(PIV1、PIV2、PIV3),采用ELISA方法检测55887例ADV病毒血清IgM抗体,其中45159例采用同样方法检测了RSV病毒血清IgM抗体。结果2529例呼吸道病毒抗原检测阳性778份(30.76%)。其中RSV阳性668份(85.86%),PIV3阳性75份(9.64%),IA阳性20份(2.57%),ADV阳性15份(1.93%),PIV1阳性仅1份(0.13%),且与RSV协同阳性。病毒血清RSV-IgM检测各年阳性率为0.9%～15.2%,ADV-IgM检测各年阳性率为0.6%～10.6%。RSV感染主要在冬春季节好发。结论重庆地区ALRI中病毒感染仍然是小儿ALRI的最常见病原,且仍以RSV感染居首,有明显季节性,以冬春季节为著。2007年1-10月均能检测到RSV病原,阳性率在2月可达50%,提示2007年可能是RSV流行的高峰年。而PIV3、IA、ADV及PIV1感染率较低,IB及PIV2近5a来均未发现。RSV病毒抗原免疫荧光检测既快速又准确,与临床诊断较符合,优于抗体检测。Objective To investigate the clinical spectrum of respiratory viruses in infants and young children with acute lower respiratory infection （ALRI） in Chongqing area from 2003 -2007. And to assess the clinical diagnostic value of virus detection in nasopharyngeal secretions（NPS） and serum viral antibody detection for ALRI. Methods Cases of 2 529 specimens of NPS in hospitalized children with ALRI from Apr. 2003 to Oct. 2007 were taken for detecting 7 common respiratory virus antigens by immunofluorescenee assay including respiratory syncytial virus （ RSV ） , adenovirus （ ADV ） , influenza A （ IA ） , influenza B （ IB ） , parainfluenza virusl - 3 （ PIVI, PIV2, PIV3 ）. Fifty - five thousand eight hundred and eighty - seven samples were tested for ADV - IgM by ELISA. Among those,45 159 cases were further tested for RSV - lgM by EIJSA. Results Respiratory virus pathogens were detected in 778 samples out of 2 529（30.76% ） including RSV positive in 668 samples （85.86%） ,PIV3 positive in 75 samples （9.64%） ,IA positive in 22 samples （2.57%） ,ADV positive in 15 samples （ 1.93% ）, only I sample （ 0.13% ） positive for both PIV1 and RSV. And the positive rate of RSV - IgM was 0.9% - 15.2% ,and the positive rate for ADV - lgM was about 0.6% - 10.6%. RSV infection occured mainly in winter and spring. Conclusions Respiratory virus is the most commou pathogen iu chihlren with ALRI during the survey period in Chongqing area,especially for RSV infection. The pattern of RSV circulation varied every year with seasonality. It is suggest that this year is peak one for RSV infection from the monthly positive results,especially in Feburary（50% ） in 2007. But the infection rate of PIV3, IA,ADV and PIV1 are lower,particularly IB and PIV2 infection have not been seen for the last 5 years. It is fast and accurate to detect RSV antigen and suit to clinical diagnosis by using immunofluorescence assay than other antibody detection.

关 键 词：急性下呼吸道感染 病毒 免疫荧光检测 儿童 重庆 

分 类 号：R725.6[医药卫生—儿科]