简阳地区2669例呼吸道感染儿童中偏肺病毒的感染情况及临床病理参数分析  

Analysis of the infection status and clinical parameters of metapneumovirus in 2669 children with respiratory tract infections in Jianyang area

作　　者：朱紫衣 李毓龙 杨晓悦 贺腊 冀承杰 ZHU Ziyi;LI Yulong;YANG Xiaoyue;HE La;JI Chengji(Department of Experimental Medicine,Jianyang People′s Hospital,Jianyang 641400,Sichuan,China)

机构地区：[1]简阳市人民医院实验医学科,四川简阳641400

出　　处：《临床检验杂志》2025年第3期222-226,共5页Chinese Journal of Clinical Laboratory Science

基　　金：四川省科技厅重点研发项目第二版(2022YF50335);成都市医学科研课题(2023564,2022128);四川省医学会课题(202350);简阳市人民医院科研课题(JY202307)。

摘　　要：目的 探讨简阳地区急性呼吸道感染儿童偏肺病毒(HMPV)感染情况及其临床病理参数。方法 选取2023年3月至2024年2月就诊于简阳市人民医院的急性呼吸道感染住院患儿2669例,采用多重PCR及毛细管电泳技术检测13项呼吸道病原体,收集HMPV感染患儿的临床资料并进行统计学分析。结果 在2669例急性呼吸道感染患儿中共有209例检出HMPV,阳性率为7.83%。阳性患儿主要集中于5岁以内儿童(73.21%),以咳嗽、发热、喘息、气促为主要临床表现。单纯HMPV感染率为58.85%,混合细菌感染率为26.69%,混合病毒感染率为13.88%。混合感染组白细胞(WBC)、淋巴细胞(LYM)、血小板(PLT)、C反应蛋白(CRP)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌钙蛋白I(cTn I)、降钙素原(PCT)水平均显著高于HMPV单纯感染组(P<0.05),而血红蛋白(Hb)、总蛋白(TP)、肌酐(Cr)水平显著低于HMPV单纯感染组(P<0.05)。相比于非重症肺炎组,重症肺炎组的WBC、Hb、PLT、CRP等水平显著升高(P<0.05)。多因素Logistic回归分析显示,年龄<3岁、合并感染、CRP≥20 mg/L是发生重症HMPV肺炎的危险因素(P<0.05)。结论 HMPV是引起简阳地区儿童急性呼吸道感染的重要病原体之一,部分实验室指标水平升高与感染的严重程度相关。早期完善细菌学检查和炎症指标的检测,有利于指导临床治疗。Objective To investigate the infection status and clinical parameters of human metapneumovirus(HMPV)in children with acute respiratory tract infections in Jianyang area.Methods A total of 2669 hospitalized children with acute respiratory tract infections at Jianyang People′s Hospital from March 2023 to February 2024 were enrolled.Thirteen kinds of respiratory pathogens were detected using multiplex PCR and capillary electrophoresis.The clinical data of HMPV-infected children were collected and analyzed.Results Out of 2669 children with acute respiratory tract infections,209 were detected with HMPV,with a positive rate of 7.83%.HMPV-positive children were mainly concentrated in under 5 years old(73.21%),with cough,fever,wheezing,and shortness of breath as main clinical manifestations.The rate of single HMPV infection was 58.85%,and those of mixed bacterial infection and mixed viral infection were 26.69%and 13.88%,respectively.The levels of white blood cells(WBC),lymphocytes(LYM),platelets(PLT),C-reactive protein(CRP),alanine aminotransferase(ALT),aspartate aminotransferase(AST),lactate dehydrogenase(LDH),troponin I(cTn I),and procalcitonin(PCT)in the mixed infection group were significantly higher than those in the single HMPV infection group(P<0.05),while the levels of hemoglobin(Hb),total protein(TP),and creatinine(Cr)were significantly lower than those in the single HMPV infection group(P<0.05).Compared with the non-severe pneumonia group,the levels of WBC,Hb,PLT,and CRP in the severe pneumonia group were significantly increased(P<0.05).Multivariate Logistic regression analysis showed that age<3 years,co-infection,and CRP≥20 mg/L were risk factors for severe HMPV pneumonia(P<0.05).Conclusion HMPV is one of the important pathogens causing acute respiratory tract infections in children in Jianyang area.The elevated levels of some laboratory indicators are associated with the severity of infection.Early and comprehensive bacteriological testing and detection of inflammatory markers are beneficial for guiding c

关 键 词：呼吸道感染 偏肺病毒 儿童 临床参数 

分 类 号：R466[医药卫生—临床医学] R725