2014—2020年儿童社区获得性肺炎中人副流感病毒感染的多中心研究  

A multicenter study on human parainfluenza virus infections among children with community-acquired pneumonia from 2014 to 2020

作　　者：蔡士奇 徐保平[3] 李昌崇[4] 孙云 卢根 靳蓉[7] 尚云晓[8] 周云连[9] 曹玲[10] 陈爱欢[11] 邓力 鲍一笑[12] 宁丽敏[13] 符州[14] 顾芳[15] 于水莲[16] 刘春艳[1] 殷菊[3] 申昆玲[3] 朱云[1,2] 谢正德 Cai Shiqi;Xu Baoping;Li Changchong;Sun Yun;Lu Gen;Jin Rong;Shang Yunxiao;Zhou Yunlian;Cao Ling;Chen Aihuan;Deng Li;Bao Yixiao;Ning Limin;Fu Zhou;Gu Fang;Yu Shuilian;Liu Chunyan;Yin Ju;Shen Kunling;Zhu Yun;Xie Zhengde(Beijing Key Laboratory of Pediatric Respiratory Infection Diseases,Key Laboratory of Major Diseases in Children,Ministry of Education,National Clinical Research Center for Respiratory Diseases,Research Unit of Critical Infection in Children,Chinese Academy of Medical Sciences,2019RU016,Laboratory of Infection and Virology,Beijing Pediatric Research Institute,Beijing Children’s Hospital,Capital Medical University,National Center for Children’s Health,Beijing 100045,China;Research Unit of Critical Infection in Children,Chinese Academy of Medical Sciences,2019RU016,Beijing 100045,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;Department of Pediatric Pulmonology,the 2nd Affiliated Hospital and Yuying Children’s Hospital,Wenzhou Medical University,Wenzhou 325027,China;Yinchuan Women and Children Healthcare Hospital,Yinchuan 750002,China;Guangzhou Women and Children’s Medical Center,Guangzhou 510623,China;Guiyang Maternal and Child Health Care Hospital,Guiyang 550003,China;Shengjing Hospital of China Medical University,Shenyang 110004,China;Children’s Hospital,Zhejiang University School of Medicine,Hangzhou 310052,China;Children’s Hospital Affiliated to Capital Institute of Pediatrics,Beijing 100020,China;The First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China;Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Children’s Hospital of Changchun,Changchun 130000,China;Children’s Hospital of Chongqing Medical University,Chongqing 400014,China;Baoding Children’s Hospital,Baoding 071051,China;The 2nd Affiliated Hospital of Harbin Medical Universi

机构地区：[1]国家儿童医学中心,国家呼吸系统临床医学研究中心,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]中国医学科学院儿童危重感染诊治创新单元,2019RU016,北京100045 [3]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 [4]温州医科大学附属第二医院育英医院,温州325027 [5]银川市妇女儿童保健院,银川750002 [6]广州市妇女儿童医疗中心,广州510623 [7]贵阳市妇幼保健院,贵阳550003 [8]中国医科大学附属盛京医院,沈阳110004 [9]浙江大学医学院附属儿童医院,杭州310052 [10]首都儿科研究所附属儿童医院,北京100020 [11]广州医科大学附属第一医院,广州510120 [12]上海交通大学医学院附属新华医院,上海200092 [13]长春市儿童医院,长春130000 [14]重庆医科大学附属儿童医院,重庆400014 [15]保定市儿童医院,保定071051 [16]哈尔滨医科大学附属第二医院,哈尔滨150001

出　　处：《中华实验和临床病毒学杂志》2023年第5期472-479,共8页Chinese Journal of Experimental and Clinical Virology

基　　金：中国医学科学院医学与健康科技创新工程(2019-I2M-5-026);国家科技重大专项(2017ZX10103004-004);国家科技支撑项目(2013BAI09B11);首都卫生发展科研专项公共卫生项目(首发2021-1G-3012)。

摘　　要：目的了解我国儿童社区获得性肺炎(community-acquired pneumonia,CAP)中人副流感病毒(human parainfluenza viruses,HPIVs)感染的流行病学特点及临床特征,为HPIVs感染诊疗和防控提供基础数据。方法2014年11月至2020年2月,在11个省和直辖市的14家医院纳入5448名CAP住院儿童,采集鼻咽抽吸物或咽拭子,使用液相悬浮芯片技术检测包括HPIV1-4型等18种呼吸道病毒核酸,收集人口学资料和临床信息进行统计学分析。结果5448例CAP住院患儿中HPIVs总检出率为8.83%(481/5448),男性检出率高于女性(62.79%v.s 37.21%,χ^(2)=0.000,P=0.992)。1~<3岁年龄组的HPIVs检出率较其它年龄组高,且差异有统计学意义(χ^(2)=61.893,P<0.001)。北方地区患儿的HPIVs检出率高于南方地区(9.02%v.s 8.65%),但差异无统计学意义(χ^(2)=0.239,P=0.625)。北方和南方地区儿童中HPIV1-4型流行特征不完全一致。HPIV1在北方和南方地区均主要为秋季流行;HPIV2在北方夏季流行,南方检出率较低;HPIV3在北方和南方春夏季是流行高峰,但南方比北方持续时间更长;HPIV4在北方和南方均主要为秋季流行。在481名HPIVs阳性患儿中,单纯HPIV感染病例占58.42%(281/481),临床表现主要以咳嗽(90.75%)和发热(68.68%)为主;合并另一种HPIV型或其它病毒感染的病例占42.62%(205/481),合并2种及以上病毒感染的病例占11.43%(55/481),HPIV3与其它病毒发生合并感染的检出率最高。47名HPIVs阳性的重症肺炎患儿中HPIV3感染占比最多(76.80%)。结论HPIVs是引起我国儿童CAP的重要病原体之一,3岁以下儿童是HPIVs感染的主要群体;各型HPIV在北方和南方地区儿童中的流行特征不完全相同;HPIV3是儿童呼吸道HPIVs感染和重症的主要型别。Objective To investigate the epidemiological and clinical characteristics of human parainfluenza viruses(HPIVs)infection among hospitalized children with community-acquired pneumonia(CAP)in China,and provide basic data for diagnosis,treatment and prevention of HPIVs infection.Methods From November 2014 to February 2020,5448 hospitalized children with CAP were enrolled in 14 hospitals in 11 provinces and municipalities directly under the Central Government in southern China and northern China.Nasopharyngeal aspirates or throat swabs were collected,and the nucleic acids of 18 types respiratory viruses including HPIV1-4 were screened by suspension array technology.Demographic data and clinical information were collected for statistical analysis.Results The total detection rate of HPIVs in 5448 children with CAP was 8.83%(481/5448),and the detection rate in males was higher than that in females(62.79%vs.37.21%;χ^(2)=0.000,P=0.992).The detection rate of HPIVs in 1~<3 years age group was higher than that in other age groups,and the difference was statistically significant(χ^(2)=61.893,P<0.001).The detection rate of HPIVs in the northern region was higher than that in the southern region(9.02%vs 8.65%),but the difference was not statistically significant(χ^(2)=0.239,P=0.625).The prevalence of HPIV1-4 in northern and southern China was not completely same.HPIV1 was mainly prevalent in autumn in both northern and southern regions.HPIV2 was prevalent in summer in northern China,and the detection rate was low in southern China.HPIV3 reached its peak in both spring and summer in both northern and southern China,but its duration was longer in southern China than in northern China.HPIV4 is mainly popular in autumn in both southern China and northern China.Among 481 children infected with HPIVs,58.42%(281/481)were infected with HPIV alone,and the main clinical manifestations were cough(90.75%)and fever(68.68%).Out of the HPIV-positive cases,42.62%(205/481)were co-infected with another type of HPIV or a different virus,while

关 键 词：人副流感病毒住院儿童 多中心研究 分子流行病学 临床特征 

分 类 号：R725.6[医药卫生—儿科]