中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2010年
10期
742-745
,共4页
杨子峰%占扬清%王玉涛%罗翌%周红%李际强%秦笙%关文达%梁增伟%招穗珊%黄群娣%莫自耀%陈敬贤%陈荣昌
楊子峰%佔颺清%王玉濤%囉翌%週紅%李際彊%秦笙%關文達%樑增偉%招穗珊%黃群娣%莫自耀%陳敬賢%陳榮昌
양자봉%점양청%왕옥도%라익%주홍%리제강%진생%관문체%량증위%초수산%황군제%막자요%진경현%진영창
流感病毒A型%流感病毒B型%流行病学
流感病毒A型%流感病毒B型%流行病學
류감병독A형%류감병독B형%류행병학
Influenza A virus%Influenza B virus%Epidemiology
目的 探讨引起广州地区成人流感样疾病(influenza like illness,ILI)的呼吸道病毒病原学分布及其临床特征.方法 2009年1-9月份采集882例成人ILI患者的鼻和(或)咽拭子,应用小瓶离心法进行病毒分离与鉴定,并对患者的临床特征进行分析.结果 (1)病原学分布:882份鼻和(或)咽拭子标本中,病毒培养阳性385份(43.7%),共检测出9种病毒,以季节性甲型流感病毒为主,共259例(67.3%),其余分别为乙型流感病毒107例(27.8%);人副流感病毒(HPIV)1～3型5例(1.3%);腺病毒、单纯疱疹病毒1型(HSV-1)及肠道病毒各2例(0.5%);混合感染8例(2.1%),其中季节性甲型流感和乙型流感病毒混合感染6例,乙型流感病毒与HPIV-3混合感染1例,腺病毒与呼吸道合胞病毒(RSV)混合感染1例.2009年3-5月份以乙型流感病毒为优势毒株,6-8月份则以季节性甲型流感病毒为主;(2)临床特征:ILI患者以18～30岁人群为主(49.7%),中度发热、咽喉痛及咳嗽为主要临床症状,上呼吸道感染和肺炎的比例为88.4%(727/882)和10.7%(95/882).季节性甲型流感和乙型流感的临床症状相似,流感病毒检测阳性组的白细胞和淋巴细胞平均数均较病毒阴性组低.腺病毒、HPIV及RSV感染者年龄较低,肠道病毒与疱疹病毒感染者未出现皮疹.结论 (1)引起2009年广州地区成人ILI的病原以季节性甲型流感和乙型流感病毒为优势病毒,其他呼吸道病毒散发,病毒病原体多样化特征不明显,呈季节性流行;(2)不同病毒感染的成人ILI患者发热程度不同,伴有明显的全身和上呼吸道症状,肺炎少见.
目的 探討引起廣州地區成人流感樣疾病(influenza like illness,ILI)的呼吸道病毒病原學分佈及其臨床特徵.方法 2009年1-9月份採集882例成人ILI患者的鼻和(或)嚥拭子,應用小瓶離心法進行病毒分離與鑒定,併對患者的臨床特徵進行分析.結果 (1)病原學分佈:882份鼻和(或)嚥拭子標本中,病毒培養暘性385份(43.7%),共檢測齣9種病毒,以季節性甲型流感病毒為主,共259例(67.3%),其餘分彆為乙型流感病毒107例(27.8%);人副流感病毒(HPIV)1～3型5例(1.3%);腺病毒、單純皰疹病毒1型(HSV-1)及腸道病毒各2例(0.5%);混閤感染8例(2.1%),其中季節性甲型流感和乙型流感病毒混閤感染6例,乙型流感病毒與HPIV-3混閤感染1例,腺病毒與呼吸道閤胞病毒(RSV)混閤感染1例.2009年3-5月份以乙型流感病毒為優勢毒株,6-8月份則以季節性甲型流感病毒為主;(2)臨床特徵:ILI患者以18～30歲人群為主(49.7%),中度髮熱、嚥喉痛及咳嗽為主要臨床癥狀,上呼吸道感染和肺炎的比例為88.4%(727/882)和10.7%(95/882).季節性甲型流感和乙型流感的臨床癥狀相似,流感病毒檢測暘性組的白細胞和淋巴細胞平均數均較病毒陰性組低.腺病毒、HPIV及RSV感染者年齡較低,腸道病毒與皰疹病毒感染者未齣現皮疹.結論 (1)引起2009年廣州地區成人ILI的病原以季節性甲型流感和乙型流感病毒為優勢病毒,其他呼吸道病毒散髮,病毒病原體多樣化特徵不明顯,呈季節性流行;(2)不同病毒感染的成人ILI患者髮熱程度不同,伴有明顯的全身和上呼吸道癥狀,肺炎少見.
목적 탐토인기엄주지구성인류감양질병(influenza like illness,ILI)적호흡도병독병원학분포급기림상특정.방법 2009년1-9월빈채집882례성인ILI환자적비화(혹)인식자,응용소병리심법진행병독분리여감정,병대환자적림상특정진행분석.결과 (1)병원학분포:882빈비화(혹)인식자표본중,병독배양양성385빈(43.7%),공검측출9충병독,이계절성갑형류감병독위주,공259례(67.3%),기여분별위을형류감병독107례(27.8%);인부류감병독(HPIV)1～3형5례(1.3%);선병독、단순포진병독1형(HSV-1)급장도병독각2례(0.5%);혼합감염8례(2.1%),기중계절성갑형류감화을형류감병독혼합감염6례,을형류감병독여HPIV-3혼합감염1례,선병독여호흡도합포병독(RSV)혼합감염1례.2009년3-5월빈이을형류감병독위우세독주,6-8월빈칙이계절성갑형류감병독위주;(2)림상특정:ILI환자이18～30세인군위주(49.7%),중도발열、인후통급해수위주요림상증상,상호흡도감염화폐염적비례위88.4%(727/882)화10.7%(95/882).계절성갑형류감화을형류감적림상증상상사,류감병독검측양성조적백세포화림파세포평균수균교병독음성조저.선병독、HPIV급RSV감염자년령교저,장도병독여포진병독감염자미출현피진.결론 (1)인기2009년엄주지구성인ILI적병원이계절성갑형류감화을형류감병독위우세병독,기타호흡도병독산발,병독병원체다양화특정불명현,정계절성류행;(2)불동병독감염적성인ILI환자발열정도불동,반유명현적전신화상호흡도증상,폐염소견.
Objective This study was undertaken to describe the viral etiology and clinical features in patients with influenza-like illness (ILI) in Guangzhou. Methods The nasopharyngeal and throat swabs were collected from 882 patients presenting with ILI between January and September, 2009. Viral pathogens were cultured and identified by immunofluorescence technique using the Shell-Vial method. The clinical data were statistically analyzed. Results (1) Viral etiology. Of the 882 samples, 385 (43.7%) were confirmed to have at least one of the 9 different respiratory viruses detected. Among these viral isolates,67. 3% (259/385) were seasonal influenza A virus, 27. 8% (107/385) were influenza B virus, and 1.3%(5/385) were human parainfluenza virus (PHIV) 1, 2, or 3. In addition, 2 cases (0.5%) of each adenovirus, HSV-1, enterovirus and respiratory syncytial virus (RSV) were also found in the samples. Coinfections with more than one virus were revealed in 8 (2. 1% ) of 385 samples tested, among them 6 samples were mixture of influenza A and influenza B, 1 sample was positive for both influenza B virus and HPIV-3, and 1 was for both adenovirus and RSV. Seasonal influenza B virus appeared endemic between March and May, and seasonal influenza A virus became dominant between June and August. (2) Clinical features. The percentage of patients aged from 18 -30 years was much higher than that of other age groups.The most common symptoms were moderate fever and sore throat, followed by cough. The percentage of upper respiratory infection and pneumonia was 88.4% ( 727/882 ) and 10. 7% ( 95/882 ) respectively.Clinical features did not discriminate between patients with seasonal influenza A and those with influenza B virus infection. The average numbers of leukocytes and lymphocytes were lower in the group positive for influenza viruses than in virus negative group. The patients with adenovirus, HPIV and RSV infection were significantly younger. No rash was observed in patients with enterovirus or HSV infection. Conclusions ( 1 ) Seasonal influenza virus was the major viral etiologic agent of ILI in Guangzhou during the first 9 months in 2009. Influenza B and A viruses seasonally prevailed in spring and summer, respectively, while other viral etiologic agents appeared to be sporadic. (2) The analysis of clinical features in patients with ILI indicated that fever was the most common symptom, with body temperature varying greatly, and may be associated with evident respiratory and occasionally systemic symptoms. Among the cases with viral infection, the upper respiratory presentation was universal, and pneumonia was frequently noticed.
