2020年深圳地区夏季儿童呼吸道合胞病毒感染的流行特征分析  

Epidemiological characteristics of respiratory syncytial virus infection in children in Shenzhen Area during summer of 2020

作　　者：刘爱良 鲍燕敏[1] 李莉[1] 王和平[1] Liu Ailiang;Bao Yanmin;Li Li;Wang Heping(Department of Respiratory,Shenzhen Children's Hospital,Shenzhen 518026,China)

机构地区：[1]深圳市儿童医院呼吸科,518026

出　　处：《中国小儿急救医学》2022年第2期123-127,共5页Chinese Pediatric Emergency Medicine

基　　金：深圳市医学重点学科建设项目(SZXK032)。

摘　　要：目的探讨深圳地区2020年夏季流行的儿童呼吸道合胞病毒(RSV)感染的临床特点及病毒血清分型特点,为本地区RSV感染的诊断、监测及防治提供依据。方法回顾分析2020年7月1日至2020年8月31日深圳市儿童医院呼吸科收治的509例RSV感染患儿的临床资料,并将诊断为肺炎的患儿按照病情轻重分为轻症RSV肺炎组和重症RSV肺炎组。分析患儿年龄、性别、临床表现、基础疾病、混合感染、临床诊断等。结果509例RSV感染患儿中,男女比1.84∶1,平均热程(3.98±3.25)d;<6个月RSV检出率51.4%(126/245),6个月~2岁45.6%(247/542),2~5岁41.8%(123/294),>5岁8.5%(13/153)。常见临床表现为咳嗽(96.2%)、发热(72.5%)、流涕(61.9%)、鼻塞(54.6%)。509例患儿中,有基础疾病123例(24.2%),混合感染49例(9.6%)。371例RSV肺炎患儿中,轻症280例(55.0%),重症91例(17.8%);与轻症RSV肺炎组相比,重症RSV肺炎组男性、年龄<1岁、喘息、有基础疾病、混合感染比例明显增高,住院时间及发热时间更长(均P<0.05)。多因素分析显示年龄<1岁、混合感染及有基础疾病是发生重症RSV肺炎的高危因素(OR值分别为10.1、14.3、3.4,均P<0.05)。198例血清分型病例中,18例为A型,180例为B型。结论2020年夏季深圳地区出现的儿童RSV感染以B型为主,除了6个月~2岁儿童外,2~5岁儿童也是易感人群,年龄<1岁、有基础疾病、混合感染是儿童重症RSV肺炎的独立危险因素。Objective To investigate the clinical characteristics and serotyping characteristics of respiratory syncytial virus(RSV)infection in children prevalent during summer of 2020 in Shenzhen City,and provide basis for the diagnosis,monitoring and prevention of RSV infection in this area.Methods The clinical data of 509 cases of RSV infection were analyzed in the Respiratory Department at Shenzhen Children′s Hospital from July 1,2020 to August 31,2020.The children diagnosed with pneumonia were divided into mild RSV pneumonia group and severe RSV pneumonia group according to the severity.The age,sex,clinical manifestations,basic diseases,mixed infection,clinical diagnosis of the patients were analyzed.Results In 509 children with RSV infection,the male to female ratio was 1.84∶1,and the mean thermal range was(3.98±3.25)d.The detection rate of RSV was 51.4%(126/245)in children aged<6 months,45.6%(247/542)in children aged from 6 months to 2 years,41.8%(123/294)in children aged from 2 to 5 years,and 8.5%(13/153)in children aged>5 years.Common clinical manifestations were cough(96.2%),fever(72.5%),runny nose(61.9%),and nasal congestion(54.6%).Of the 509 cases,123(24.2%)had underlying diseases and 49(9.6%)had mixed infections.A total of 371 cases had RSV pneumonia,including 280 mild cases(55.0%)and 91 severe cases(17.8%).Compared with the mild RSV pneumonia group,the severe RSV pneumonia group was significantly higher in male,age<1 years,proportion of wheezing,underlying disease,mixed infection,and hospitalization time and fever time(all P<0.05).Multivariate analysis showed that age less than 1 year,mixed infection and underlying diseases were the high risk factors of severe RSV pneumonia(OR=10.1,14.3 and 3.4,respectively,all P<0.05).Of the 198 serotyping cases,18 were type A and 180 were type B.Conclusion During the summer of 2020,the epidemic of RSV infection in children in Shenzhen is dominated by type B.In addition to children aged from 6 months to 2 years,children aged 2-5 years are also susceptible groups.Age<1 ye

关 键 词：儿童 呼吸道合胞病毒 流行 临床特征 

分 类 号：R725.6[医药卫生—儿科] R181.3[医药卫生—临床医学]