人博卡病毒与儿童呼吸道感染和腹泻病临床相关性的前瞻性病例对照研究  

Clinical relevance of human bocavirus with acute respiratory tract infection and diarrhea in children： a prospective case-control study

作　　者：曾玫[1] 王晓红[1] 俞蕙[1] 朱启镕[1] 

机构地区：[1]复旦大学附属儿科医院感染科,上海201102

出　　处：《中华儿科杂志》2010年第8期580-584,共5页Chinese Journal of Pediatrics

基　　金：国家自然科学基金（30771894）;上海市卫生局重点学科建设项目（08GWZX0102）

摘　　要：目的 通过前瞻性的病例对照研究探讨人博卡病毒（human bocavirus,HBOV）对于儿童急性呼吸道感染以及腹泻病的临床致病意义.方法 2008年10至12月,我们采集了436份急性下呼吸道感染住院患儿和150份术后患儿的鼻咽分泌物标本.同期,收集220例因急性腹泻在我院门诊就诊的患儿和200例无腹泻症状儿童的粪便标本.HBOV检测采用荧光定量多聚酶链反应方法.结果 HBOV在436份呼吸道感染患儿的鼻咽分泌物中阳性检出率10.3%（45/436）,而无呼吸道感染儿童的鼻咽分泌物标本中阳性率仅0.7%（1/150）,2组HBOV检出率差异有统计学意义（χ^2=14.356,P〈0.001）.HBOV与其他呼吸道病毒及肺炎支原体混合感染率为44.7%（20/45）.呼吸道HBOV感染患儿的年龄为1.3～72个月[平均（18.3±13.6）个月].HBOV在腹泻组粪便中检出率为2.7%（6/220）,在无腹泻症状组粪便中检出率为2%（4/200）,2组HBOV阳性率差异无统计学意义（P〉0.05）.6例HBOV阳性的腹泻患儿中,5例同时合并轮状病毒感染.粪便中HBOV阳性的患儿都在4岁以下.结论 HBOV呼吸道感染通常见于婴幼儿.本研究支持HBOV与儿童时期的急性下呼吸道感染有关,但是HBOV对儿童腹泻的致病性未能确定.Objective To explore the causative role of human bocavirus （HBOV） played in acute respiratory infection and diarrhea in children, a case-control study was prospectively conducted to investigate HBOV detection in symptomatic children with acute respiratory tract infection, diarrhea and asymptomatic children. Method Between Oct. and Dec. of 2008, 436 nasopharyngeal aspirates （NPA） from hospitalized children with acute respiratory infection and 150 NPA from asymptomatic children undergoing cardiac operations were consecutively collected. During the same time, 220 stool samples were taken from outpatients with acute watery diarrhea and 200 control specimens were obtained from children without diarrhea. HBOV was screened in all samples by real-time PCR method. HBOV-positive respiratory samples were tested for other 9 common respiratory viruses and Mycoplasma pneumoniae. HBOV-positive fecal samples were also tested for common enteric viruses causing diarrhea. Result HBOV was detected in NPA samples from 45 （10. 3% ） of 436 symptomatic patients and from 1（0. 7% ） of 150 asymptomatic control children. There was a statistically significant difference in the detection rates of HBOV between the symptomatic group and the asymptomatic group （P 〈 0. 001 ） . HBOV co-existence with other respiratory pathogens occurred in 44. 7% （20/45） of NPA from symptomatic patients. HBOV was detected in 10. 3% （43/417） children with community-acquired respiratory infection and 10.5% （2/19 ） children with nosocomial respiratory infection. Children with HBOV infection were 1. 3 to 72 months of age （mean; 18. 3 ±13. 6 months）. HBOV was found positive in 6 （2. 7% ） of 220 stool samples from diarrheal outpatients and in 4 （2% ） of 200 control samples. All children with HBOV positive detection in the stool samples were less than 4 years old. No statistical significance was found （P 〉 0. 05 ） in HBOV between diarrhea patients and asymptomatic ones. In addition, 5 of 6 HBOV-positive fecal specimens

关 键 词：呼吸道感染 腹泻 儿童 人博卡病毒 

分 类 号：R72[医药卫生—儿科]