2017-2020年我国儿童急性下呼吸道感染住院病例中呼吸道合胞病毒的感染情况分析  

Analysis of respiratory syncytial virus infection in hospitalized children with acute lower respiratory tract infection in China from 2017 to 2020

作　　者：朱云[1] 卢根 靳蓉[3] 孙云 尚云晓[5] 艾军红[1] 王然 陈祥鹏[1] 段亚丽 张萌[1] 李昌崇[6] 徐保平[7] 谢正德[1] Zhu Yun;Lu Gen;Jin Rong;Sun Yun;Shang Yunxiao;Ai Junhong;Wang Ran;Chen Xiangpeng;Duan Yali;Zhang Meng;Li Changchong;Xu Baoping;Xie Zhengde(Laboratory of Infection and Virology,Beijing Pediatric Research Institute,Beijing Key Laboratory of Pediatric Respiratory Infection Diseases,Research Unit of Critical Infection in Children,Chinese Academy of Medical Sciences,Beijing Children′s Hospital,Capital Medical University,Key Laboratory of Major Diseases in Children,Ministry of Education,National Clinical Research Center for Respiratory Diseases,National Center for Children′s Health,Beijing 100045,China;Guangzhou Women and Children′s Medical Center,Guangzhou 510623,China;Guiyang Maternal and Child Health Care Hospital,Guiyang 550003,China;Yinchuan Women and Children Healthcare Hospital,Yinchuan 750001,China;Shengjing Hospital of China Medical University,Shenyang 110004,China;The Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University,Wenzhou 325027,China;Department of Respiratory Diseases I,Beijing Children′s Hospital,Capital Medical University,National Clinical Research Center for Respiratory Diseases,National Center for Children′s Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,国家呼吸系统疾病临床医学研究中心,首都医科大学附属北京儿童医院,儿科重大疾病研究教育部重点实验室,中国医学科学院儿童危重感染诊治创新单元,儿童呼吸道感染性疾病研究北京市重点实验室,北京市儿科研究所,感染与病毒研究室,北京100045 [2]广州市妇女儿童医疗中心,广州510623 [3]贵阳市妇幼保健院,贵阳550003 [4]银川市妇幼保健院,银川750001 [5]中国医科大学附属盛京医院,沈阳110004 [6]温州医科大学附属第二医院育英儿童医院,温州325027 [7]国家儿童医学中心,国家呼吸系统疾病临床医学研究中心,首都医科大学附属北京儿童医院呼吸一科,北京100045

出　　处：《中华预防医学杂志》2022年第12期1739-1744,共6页Chinese Journal of Preventive Medicine

基　　金：北京市自然科学基金项目(7204258);中国医学科学院医学与健康科技创新工程项目(2019-I2M-5-026);首都卫生发展科研专项公共卫生项目(首发2021-1G-3012);国家科技重大专项课题(2017ZX10103004-004)。

摘　　要：目的了解我国儿童急性下呼吸道感染(ALRTI)住院病例呼吸道合胞病毒(RSV)的感染状况。方法于2017年6月至2020年3月,在我国华北地区的首都医科大学附属北京儿童医院、东北地区的中国医科大学附属盛京医院、西北地区的银川市妇幼保健院、华南地区的广州市妇女儿童医疗中心、东南地区的温州医科大学附属第二医院、育英儿童医院和西南地区的贵阳市妇幼保健院开展前瞻性儿童ALRTI病例感染RSV的多中心研究,最终共纳入2839例病例。采集儿童ALRTI住院病例的呼吸道样本,使用多重实时荧光定量PCR方法筛检样本中的16种呼吸道病毒,分析儿童ALRTI住院病例中RSV感染状况。结果RSV总检出率为18.6%(528/2839);各地区RSV检出率5.5%~44.3%。男童的RSV检出率高于女童检出率(20.2%比16.3%)(P=0.009)。<5岁年龄组的RSV检出率(22.3%,501/2245)高于5~18岁组(4.5%,27/594),差异有统计学意义(χ^(2)=97.98,P<0.001);<6月龄组患儿的RSV检出率(37.0%)高于其他年龄组,且差异有统计学意义(均P<0.001)。2018年1月至2019年12月,RSV全年均有检出(除2019年6月和7月),冬春季是流行高峰。270例重症肺炎病例中,RSV核酸阳性病例占比为17.0%(46/270),其中36例为单纯RSV感染。结论RSV是引起我国5岁以下儿童ALRTI的常见病毒病原体;全年均可检出,并呈现出冬春季流行高峰。Objective To understand the detection rate,epidemic pattern of respiratory syncytial virus(RSV)in hospitalized children with acute lower respiratory tract infection(ALRTI)in China.Methods From June 2017 to March 2020,a prospective multi-center study on the viral aetiology among hospitalized children with ALRTI was conducted in six pediatrics hospital of North China,Northeast,Northwest,South China,Southeast,and Southwest China.A total of 2839 hospitalized children with ALRTI were enrolled,and the respiratory specimens were collected from these cases.A multiplex real-time RT-PCR assay were employed to screen the respiratory viruses,and the molecular epidemiological and clinical characteristics of children infected with RSV were analyzed.Results The positve rate of RSV was 18.6%(528/2839),and the positive rate of RSV in different regions ranged from 5.5%to 44.3%.The positive rate of RSV in male was higher than that in female(20.2%vs 16.3%),and there was a significant statistically difference between two groups(χ^(2)=6.74,P=0.009).The positive rate of RSV among children under 5 years old was higher than that among children older than 5 years old(22.3%vs 4.5%),and there was a significant statistically difference between two groups(χ^(2)=97.98,P<0.001).The positive rate of RSV among the<6 months age group was higher than that of other age groups(all P<0.05).During January 2018 and December 2019,RSV was detected in almost all through the year,and showed peaks in winter and spring.RSV-positive cases accounted for 17.0%(46/270)among children with severe pneumonia,including 36 cases infected with RSV alone.Conclusion RSV is an important viral pathogen in children under 5 years old with ALRTI in China.The virus can be detected almost all through the year and reached the peak in winter and spring.RSV could lead to severe pneumonia in children and caused huge threaten to children′s health.

关 键 词：呼吸道合胞病毒 儿童急性下呼吸道感染 全国多中心研究 

分 类 号：R725.6[医药卫生—儿科]