2017-2023年四川省呼吸道病毒感染的流行病学特征分析  

Epidemiological analysis of respiratory virus infections in Sichuan Province from 2017 to 2023

作　　者：王中浩 杨岚[2] 吴思颖[1] 巫丽娟[1] 李小娴 王旻晋[1] Wang Zhonghao;Yang Lan;Wu Siying;Wu Lijuan;Li Xiaoxian;Wang Minjin(Department of Laboratory Medicine,Clinical Laboratory Medicine Research Center,West China Hospital,Sichuan University,Sichuan Clinical Research Center for Laboratory Medicine,Chengdu 610041,China;Department of Laboratory Medicine,West China Xiamen Hospital,Sichuan University,Xiamen 361022,China;Department of Medical Laboratory Medicine,Longhua District Central Hospital,Shenzhen 518110,China)

机构地区：[1]四川大学华西医院实验医学科,华西医院临床检验医学研究中心,四川省医学检验临床医学研究中心,成都610041 [2]四川大学华西厦门医院实验医学科,厦门361022 [3]深圳市龙华区中心医院医学检验科,深圳518110

出　　处：《中华微生物学和免疫学杂志》2024年第7期573-579,共7页Chinese Journal of Microbiology and Immunology

基　　金：国家自然科学基金青年项目(82102485);四川省自然科学基金青年基金项目(2024NSFSC1549)。

摘　　要：目的回顾分析2017—2023年四川省呼吸道病毒感染情况,探究不同病毒的检出率及其在不同时期和不同年龄段的变化特征。方法本研究共纳入41516例急性呼吸道感染患者,回顾临床实验室检测结果以统计不同病毒检出率,并对COVID-19疫情前后、混合感染、不同季节和不同年龄段的感染情况进行分析。结果呼吸道病毒整体检出率为23.35%(9696/41516),甲型流感病毒(8.47%,3515/41516)、鼻病毒(7.13%,2961/41516)、乙型流感病毒(2.04%,846/41516)居前三位。0~14岁少年儿童的阳性检出率最高(48.62%,1429/2939),青年、中年和老年阶段的检出率大致相同[21.00%(1482/7057)、22.06%(3828/17350)、20.33%(2685/13205)]。COVID-19疫情期间甲型流感病毒检出率降至1.35%(253/18717),疫情后回升至13.05%(1560/11953)。人偏肺病毒、乙型流感病毒、冠状病毒和呼吸道合胞病毒在疫情期间的检出率同样显著降低,疫情后又显著回升甚至超过疫情前水平。腺病毒、博卡病毒、鼻病毒从疫情前到疫情后阶段的检出率逐渐下降,副流感病毒则保持稳定,表明COVID-19疫情对这些病毒的流行无显著影响。呼吸道病毒在秋、冬季整体检出率较高[28.90%(2324/8041)和26.52%(4093/15433)],春、夏季较低[17.61%(1848/10494)和18.96%(1431/7548)],表明季节变化对呼吸道病毒检出率有显著影响(P<0.001)。本研究共检出单病毒感染8666例,双重混合感染948例,三重感染77例,以及5例四重感染。双重感染中以博卡病毒与鼻病毒的组合最常见(17.41%,165/948),且双重感染中的59.60%(565/948)均与鼻病毒有关。结论秋冬季节的呼吸道病毒检出率高于春夏季节,COVID-19疫情期间流感病毒等的检出率降低,在不同年龄阶段均存在多重感染的情况,双重感染中鼻病毒检出率较高。Objective To analyze the epidemiological characteristics of respiratory virus infections in Sichuan from 2017 to 2023,and investigate the changes in detection rates of various viruses in different periods and age groups.Methods The study included 41516 patients with acute respiratory infections.Clinical laboratory results of these patients were retrospectively collected to calculate the detection rates of various viruses.The epidemiological characteristics of respiratory virus infections before,during,and after the COVID-19 pandemic,the prevalence of mixed infections,and the detection rates in different seasons and age groups were analyzed.Results The overall detection rate of respiratory viruses was 23.35%(9696/41516),with influenza A virus(8.47%,3515/41516),rhinovirus(7.13%,2961/41516),and influenza B virus(2.04%,846/41516)being the most prevalent.The highest detection rate was observed in children aged 0-14 years(48.62%,1429/2939),while the detection rates in young,middle-aged,and elderly individuals were similar[21.00%(1482/7057),22.06%(3828/17350),20.33%(2685/13205)].The detection rate of influenza A virus dropped to 1.35%(253/18717)during the COVID-19 pandemic,and rebounded to 13.05%(1560/11953)after the pandemic.A similar pattern was observed in other viruses such as human metapneumovirus,influenza B virus,coronavirus,and respiratory syncytial virus,with significant reductions during the COVID-19 pandemic and subsequent increases that even exceeded pre-pandemic levels.The detection rates of adenovirus,bocavirus,and rhinovirus gradually decreased over time,while the prevalence of parainfluenza virus remained stable,indicating a less significant impact of COVID-19 on these viruses.Higher detection rates were observed in autumn(28.90%,2324/8041)and winter(26.52%,4093/15433)as compared to that in spring(17.61%,1848/10494)and summer(18.96%,1431/7548),suggesting significant seasonal impacts on virus detection rates(P<0.001).This study identified 8666 cases of single-virus infections,948 double infections,77 trip

关 键 词：呼吸道病毒 COVID-19 流感 混合感染 

分 类 号：R511[医药卫生—内科学] R181.3[医药卫生—临床医学]