难治性社区获得性肺炎的住院儿童病毒感染状况研究  

Viral Infections of Refractory Community-acquired pneumonia children hospitalized in Chengdu

作　　者：杨涛毅[1,2] 郭丽春[1,2] 陈桂华[1,2] 张彤[1,2] 

机构地区：[1]成都市第三人民医院,四川成都610031 [2]重庆医科大学成都第二临床学院,四川成都610031

出　　处：《四川医学》2015年第8期1084-1087,共4页Sichuan Medical Journal

摘　　要：目的通过住院患儿社区获得性肺炎(CAP)和难治性社区获得性肺炎(RCAP)病毒感染临床特点的比较,了解成都地区病毒性RCAP的住院儿童的感染状况和特点,为RCAP的预防和治疗提供理论依据。方法对391例RCAP和CAP住院患儿痰液进行流感病毒、副流感病毒、呼吸道合胞病毒、冠状病毒、人偏肺病毒、人博卡病毒、人腺病毒、人鼻病毒和肠道病毒核酸检测及EB病毒和巨细胞病毒Ig M抗体检测,痰液和血清细菌学和非典型病原体的检测。结果在391例住院肺炎患儿检测出病毒检测阳性24.81%,110株病毒。在冬季病毒检出率最高为43.58%,不同性别患者之间病毒检出率差异。193例RCAP病毒检测阳性患儿20.73%(47株),腺病毒、人偏肺病毒和EB病毒感染占前3位,混合感染占78.72%。结论病毒感染是RCAP主要致病菌之一,病毒在RCAP中有较低的检出率,混合感染和病毒感染种类不同是导致RCAP的原因之一。Objective To understand the common viral infections of Community acquired pneumonia children hospitalized in Chengdu and provide theoretical basis for the prevention. Methods Collecting 391 specimens of RCAP and CAP children from the hospitals in Chengdu during November,2012 to October,2014. Common respiratory viruses including influenza virus,parainflu- enza virus, respiratory syncytial virus, coronavirus, human metapneumovirus, human boca virus, human adenovirus, human rhinovi- rus and enterovirus were detected in 391 sputum specimens simultaneous-Resultsly by multiplex RT- PCR. EBVCA-IgG , EB- VEA-Ig M and CMV-IgM were detected by ELISA. Results Totally 97 positive samples were identified from 391 specimens,the positive rate was 24.81% （92/391） , The positive rate was 20.73 % （40/193） in RCAP children, in which, the mostly detected human metapneumovirus,human adenovirus and EB-Viral. The highest detection rate of virus in winter was 43.58% and the de- tection rate was not statistically significant between children of different gender. 193 cases of children with RCAP get viral positive identification with other pathogens at the same time were for 34cases （78.72%）. Conclusion Virall infection is one of the CAP and RCAP children hospitalization main pathogens. Viral infection of RCAP had a lower detection rate. Human metapneumovirus, adenovirus, and EB-Viral rhinovirus were the main pathogens leading to the RCAP in Chengdu, mixed infections were common.

关 键 词：儿童 难治性 社区获得性肺炎 病毒 

分 类 号：R725.6[医药卫生—儿科]