2010至2012年门诊和住院儿童急性呼吸道感染病毒病原比较分析  

Viral etiology of acute respiratory tract infection among pediatric inpatients and outpatients from 2010 to 2012 in Beijing, China

作　　者：刘春艳[1] 肖艳 谢正德[1] 任丽丽[3] 胡英惠[2] 幺远[3] 杨燕[3] 钱素云[4] 赵成松[5] 申昆玲[2] 

机构地区：[1]首都医科大学附属北京儿童医院北京市儿科研究所儿科学国家重点学科省部共建儿科重大疾病研究重点实验室,100045 [2]首都医科大学附属北京儿童医院呼吸科 儿科学国家重点学科 [3]首都医科大学附属北京儿童医院呼吸科 中医科 [4]首都医科大学附属北京儿童医院呼吸科 急救中心 [5]首都医科大学附属北京儿童医院呼吸科 门诊部 [6]中国医学科学院病原生物学研究所,100730

出　　处：《中华儿科杂志》2013年第4期255-259,共5页Chinese Journal of Pediatrics

基　　金：国家科技重大专项课题（2012ZX10004-206）;国家科技支撑计划课题（2012BA103802）

摘　　要：目的了解同期门诊和住院儿童急性呼吸道感染的病毒病原特点及流行特征。方法2010年3月至2012年2月首都医科大学附属北京儿童医院门诊及住院的临床诊断为急性呼吸道感染的患儿共2066例。其中门诊病例1050例，住院病例1016例。每例患儿采集咽拭子或鼻咽吸取物标本1份，采用逆转录聚合酶链反应（RT-PCR）方法进行呼吸道病毒核酸检测，包括呼吸道合胞病毒、鼻病毒、副流感病毒1～4型、流感病毒、腺病毒、肠道病毒、冠状病毒、偏肺病毒及博卡病毒。结果本组病例中，1274例检出至少1种病毒，总的病毒检出率为61．7％，住院患儿检出率（69．7％）高于门诊患儿（53．9％）（χ2=54．394，P〈0．001）。呼吸道合胞病毒是住院急性呼吸道感染患儿最主要病原，其次是鼻病毒、副流感病毒；流感病毒在门诊病例检出率最高，其次是腺病毒、副流感病毒。377例检出2种或2种以上病毒，住院患儿混合感染率（30．1％）高于门诊患儿（6．8％）（χ2=188．820，P〈0．001）。结论门诊患儿流感病毒检出率最高，而呼吸道合胞病毒是住院患儿中最常检出的病毒。多种病毒混合感染在急性呼吸道感染儿童较常见，特别是住院病例，但其临床意义还有待进一步研究。Objective Acute respiratory tract infections （ARI） are the leading cause of pediatric morbidity and mortality worldwide, particularly in developing countries. Viruses are the main pathogens of ARI in children. The purpose of the present study was to determine the epidemiologic features of respiratory viruses, including novel viruses, in outpatient and hospitalized children with ARI. Method From March 2010 to February 2012, 2066 children with ARI, including 1050 outpatients and 1016 inpatients, were involved in this study. One nasopharyngeal aspirate or throat swab specimen was collected from each patient. Reverse transcription （RT） PCRs were performed to detect common respiratory tract viruses including respiratory syncytial virus （RSV）, human rhinovirus （HRV）, influenza virus （IFV）, parainfluenza virus （PIV） type 1-4, adenovirus （ADV）, enterovirus （EV）, human coronavirus （HCOV）, human metapneumonia virus （HMPV） and human bocavirus （HBOV）. Result At least one viral pathogen was identified in each of 1274 out of 2066 patients and the overall positive rate was 61.7%. The positive rate in inpatient （69. 7% ） was higher than that in outpatient （53.9%）. The frequencies of detection of various viruses among in- and outpatients were different. RSV was the most prevalent virus detected among hospitalized children, followed by HRV and PIV, whereas IFV was the most frequently identified virus in theoutpatient group, followed by ADV and PIV. Simultaneous detection of two or more viruses was found in 377 cases. Coinfection was more frequent in inpatients than in outpatients （30. 1% vs. 6. 8%, P 〈 0. 001 ）. Conclusion Respiratory viruses play an important role in children with ARI, especially in young children. RSV was the most prevalent virus detected among hospitalized children, whereas IFV was the most frequently identified virus in the outpatient group. Viral coinfections are frequently identified, particularly in hospitalized patients. Further studies are required

关 键 词：呼吸道感染 儿童 病毒 

分 类 号：R72[医药卫生—儿科]