机构地区:[1]宁夏医科大学临床医学院,银川750004 [2]宁夏医科大学基础医学院,银川750004 [3]宁夏医科大学总医院小儿外科,银川750004 [4]银川市妇幼保健院检验科,银川750001 [5]宁夏医科大学总医院呼吸与危重症医学科,银川750004
出 处:《福建医科大学学报》2024年第3期182-187,共6页Journal of Fujian Medical University
基 金:国家自然科学基金地区项目(81560340);宁夏自然科学基金项目(2021AAC02010)。
摘 要:目的探讨银川市社区获得性肺炎(CAP)住院儿童人偏肺病毒(HMPV)的感染情况及临床特点。方法收集2018年1月—2019年12月在银川市妇幼保健院住院的CAP患儿878例,采集患儿的下呼吸道分泌物样本,采用多重PCR检测包括HMPV、呼吸道合胞病毒(RSV)、人冠状病毒229E/NL63、腺病毒(AdV)、副流感病毒(PIV)1、2、3型和人博卡病毒(HBoV)等15种常见呼吸道病毒。回顾性分析HMPV阳性病例的流行病学资料、临床表现和实验室检查结果等资料。结果878例中,HMPV阳性140例(15.95%),其中HMPV单独感染32例(22.86%)、合并其他病毒感染71例(50.71%)、合并细菌感染8例(5.71%)、合并其他病毒和细菌感染24例(17.14%)、合并支原体抗体阳性5例(3.58%)。合并感染的其他病毒主要有人鼻病毒(HRV)、PIV3和RSV,合并感染的细菌主要有肺炎克雷伯杆菌、大肠埃希菌和肺炎链球菌。HMPV感染的高发季节为春、夏季,感染的主要群体为≤5岁的儿童。49例CAP重症病例中,HMPV阳性7例(14.29%),均合并其他病毒或细菌感染。主要临床表现有咳嗽、发热和咽部充血症状。与其他病原体感染者比较,单独HMPV阳性者白细胞计数低(P<0.05)。HMPV阳性的重症CAP患儿,白细胞计数和肌酐(Cr)含量均低于阴性患儿,差别有统计学意义(P<0.01,P<0.05),其他临床症状及相关指标的差别无统计学意义(P>0.05)。结论HMPV是银川市儿童CAP的常见病原体之一,常合并其他病原微生物感染;HMPV感染高发于春、夏季,好发于≤5岁的儿童。Objective To investigate epidemiological and clinical characteristics of human metapneumovirus(HMPV)in 878 hospitalized children with community-acquired pneumonia(CAP)in Yinchuan City.Methods A total of 878 hospitalized children with CAP in Yinchuan Women and Children Healthcare Hospital were observed from January 2018 to December 2019.Specimens of lower respiratory tract secretions were collected and tested for 15 common respiratory viruses including HMPV,respiratory syncytial virus(RSV),human coronavirus(HCoV)229E/NL63,adenovirus(AdV),parainfluenza virus(PIV)types 1,2 and 3,human bocavirus(HBoV)and other viruses by multiplex PCR analysis.The epidemiological data,clinical manifestations and laboratory tests of HMPV-positive cases were retrospectively analyzed.Results Of the 878 hospitalized children with CAP,140 cases(15.95%)were positive for HMPV,of which 32 cases(22.86%)were positive for single HMPV infection,71 cases(50.71%)were co-infected with other viruses,8 cases(5.71%)were co-infected with bacteria,24 cases(17.14%)were infected together with other viruses and bacteria,and 5 cases(3.58%)were positive for mycoplasma antibody test.The main types of other viruses co-infected with HMPV were HRV,PIV3 and RSV,and the main types of co-infected bacteria were Klebsiella pneumoniae,Escherichia coli and Streptococcus pneumoniae.HMPV infection had high incidence in spring and summer and its infection was mainly in the children of 5 years old or below.Among the 49 severe CAP cases,7 cases(14.29%)were positive for HMPV,all of whom were co-infected with other viruses and bacteria.The main clinical manifestations included cough,fever and pharyngeal congestion.Compared with patients infected with other pathogens,patients with single HMPV positivity had lower white blood cell(WBC)counts(P<0.05),and the WBC counts and creatinine(Cr)levels of HMPV positive children with severe CAP were lower than those of HMPV-negative patients,with statistically significant differences(P<0.01,P<0.05).There was no statistically significant d
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