目的 了解苏州地区儿童急性呼吸道感染(acute respiratory infection,ARI)的病毒病原情况,指导临床进行诊断与治疗.方法 对苏州大学附属儿童医院2005年11月-2007年5月间住院的2492例ARI患儿采用无菌负压吸引法采集新鲜痰液,采用直接免疫荧光法检测7种病毒,即呼吸道合胞病毒(respirations syncytial virus,RSV),腺病毒(adenovirus,ADV),流感病毒A、B型(influenza virus-A,Inf-A;influenza virus-B,Inf-B),副流感病毒1、2、3型(parainfluenze viru-1,Pinf-1;parainfluenze viru-2,Pinf-2;parainfluenze viru-3,Pinf-3).同时用逆转录聚合酶链反应(RT-PCR)法进行人偏肺病毒(human metapneumovirus,hMPV)检测.结果 送检标本2492例,总病毒阳性率38.6%(961/2492),总阳性检出率与年龄、季节及病种有关[年龄:各年龄组总病毒检出阳性率分别为:50.0%(412/824),43.4%(190/438),30.5%(207/679)和27.6%(152/551),x~2=96.5002,P<0.01;季节:春夏秋冬四季总病毒检出阳性率分别为:46.7%(366/784),13.8%(66/478),13.8%(59/428)和58.6%(470/802),x~2=392.3279,P<0.01;病种:各种临床疾病(上呼吸道感染、急性喉炎、喉-气管-支气管炎、支气管肺炎、大叶性肺炎、毛细支气管炎、支气管哮喘)总病毒检出阳性率分别为:21.4%(30/140),73.7%(14/19),32.0%(8/25),36.9%(598/1620),13.1%(8/61),66.1%(216/327)和29.0%(87/300),x~2=162.1276,P<0.01],与性别无关[男女总病毒阳性率分别为:39.0%(588/1508)和37.9%(373/984),x~2=0.2962,P>0.05],其次为hMPV 20.6%(198/961).RSV流行高峰主要集中在12-3月份,以毛细支气管炎感染率50.2%(164/327)最高,hMPV全年均可检出,冬季检出率13.2%(106/802)最高.结论 RSV和hMPV是苏州地区ARI患儿的主要病毒病原,通过检测儿童呼吸道感染疾病的病毒病原,可对临床提供快速、准确的诊断依据,防止滥用抗生素.
目的 瞭解囌州地區兒童急性呼吸道感染(acute respiratory infection,ARI)的病毒病原情況,指導臨床進行診斷與治療.方法 對囌州大學附屬兒童醫院2005年11月-2007年5月間住院的2492例ARI患兒採用無菌負壓吸引法採集新鮮痰液,採用直接免疫熒光法檢測7種病毒,即呼吸道閤胞病毒(respirations syncytial virus,RSV),腺病毒(adenovirus,ADV),流感病毒A、B型(influenza virus-A,Inf-A;influenza virus-B,Inf-B),副流感病毒1、2、3型(parainfluenze viru-1,Pinf-1;parainfluenze viru-2,Pinf-2;parainfluenze viru-3,Pinf-3).同時用逆轉錄聚閤酶鏈反應(RT-PCR)法進行人偏肺病毒(human metapneumovirus,hMPV)檢測.結果 送檢標本2492例,總病毒暘性率38.6%(961/2492),總暘性檢齣率與年齡、季節及病種有關[年齡:各年齡組總病毒檢齣暘性率分彆為:50.0%(412/824),43.4%(190/438),30.5%(207/679)和27.6%(152/551),x~2=96.5002,P<0.01;季節:春夏鞦鼕四季總病毒檢齣暘性率分彆為:46.7%(366/784),13.8%(66/478),13.8%(59/428)和58.6%(470/802),x~2=392.3279,P<0.01;病種:各種臨床疾病(上呼吸道感染、急性喉炎、喉-氣管-支氣管炎、支氣管肺炎、大葉性肺炎、毛細支氣管炎、支氣管哮喘)總病毒檢齣暘性率分彆為:21.4%(30/140),73.7%(14/19),32.0%(8/25),36.9%(598/1620),13.1%(8/61),66.1%(216/327)和29.0%(87/300),x~2=162.1276,P<0.01],與性彆無關[男女總病毒暘性率分彆為:39.0%(588/1508)和37.9%(373/984),x~2=0.2962,P>0.05],其次為hMPV 20.6%(198/961).RSV流行高峰主要集中在12-3月份,以毛細支氣管炎感染率50.2%(164/327)最高,hMPV全年均可檢齣,鼕季檢齣率13.2%(106/802)最高.結論 RSV和hMPV是囌州地區ARI患兒的主要病毒病原,通過檢測兒童呼吸道感染疾病的病毒病原,可對臨床提供快速、準確的診斷依據,防止濫用抗生素.
목적 료해소주지구인동급성호흡도감염(acute respiratory infection,ARI)적병독병원정황,지도림상진행진단여치료.방법 대소주대학부속인동의원2005년11월-2007년5월간주원적2492례ARI환인채용무균부압흡인법채집신선담액,채용직접면역형광법검측7충병독,즉호흡도합포병독(respirations syncytial virus,RSV),선병독(adenovirus,ADV),류감병독A、B형(influenza virus-A,Inf-A;influenza virus-B,Inf-B),부류감병독1、2、3형(parainfluenze viru-1,Pinf-1;parainfluenze viru-2,Pinf-2;parainfluenze viru-3,Pinf-3).동시용역전록취합매련반응(RT-PCR)법진행인편폐병독(human metapneumovirus,hMPV)검측.결과 송검표본2492례,총병독양성솔38.6%(961/2492),총양성검출솔여년령、계절급병충유관[년령:각년령조총병독검출양성솔분별위:50.0%(412/824),43.4%(190/438),30.5%(207/679)화27.6%(152/551),x~2=96.5002,P<0.01;계절:춘하추동사계총병독검출양성솔분별위:46.7%(366/784),13.8%(66/478),13.8%(59/428)화58.6%(470/802),x~2=392.3279,P<0.01;병충:각충림상질병(상호흡도감염、급성후염、후-기관-지기관염、지기관폐염、대협성폐염、모세지기관염、지기관효천)총병독검출양성솔분별위:21.4%(30/140),73.7%(14/19),32.0%(8/25),36.9%(598/1620),13.1%(8/61),66.1%(216/327)화29.0%(87/300),x~2=162.1276,P<0.01],여성별무관[남녀총병독양성솔분별위:39.0%(588/1508)화37.9%(373/984),x~2=0.2962,P>0.05],기차위hMPV 20.6%(198/961).RSV류행고봉주요집중재12-3월빈,이모세지기관염감염솔50.2%(164/327)최고,hMPV전년균가검출,동계검출솔13.2%(106/802)최고.결론 RSV화hMPV시소주지구ARI환인적주요병독병원,통과검측인동호흡도감염질병적병독병원,가대림상제공쾌속、준학적진단의거,방지람용항생소.
Objective To investigate the pathogen of children with acute respiratory infection (ARI) in Suzhou and to provide some evidences for clinical diagnosis and treatment. Methods The nasopharyngeal secretion samples from 2492 inpatient children with ARI,during the period of November 2005 to May 2007,were investigated for respiratory syncycial virus(RSV), influenza virus A and B, parainfluenza virus type 1,2,3 and adenovirus by both the indirect immunofluorecence assay and virus isolation. Human metapneumovirus (hMPV) were examined by reverse-transcription polymerase chain reaction (RT-PCR) at the same time. Results Of 2492 samples tested,961 (38.6%) were positive. The total positive rate of virus pathogens in children with ARI was found related to age, season and respiratory disease. The detection rates by age were: 50.0% (412/824), 43.4% (190/438), 30. 5% (207/679) and 27. 6% (152/551), x~2=96. 5002, P<0.01;the detection rates by season were: 46.7% (366/784), 13.8% (66/478), 13.8% (59/ 428) and 58.6% (470/802), x~2=392. 3279, P<0.01; the detection rates by disease were (acute upper respiratory infection, acute laryngitis, throat-trachea-bronchitis, bronchial pneumonia, pneumonia genuina, bronchiolitis, bronchial asthma):21.4% (30/140),73.7% (14/19),32.0% (8/25),36.9% (598/1620),13.1% (8/61), 66. 1% (216/327) and 29.0% (87/300),x~2=162. 1276, P < 0. 01. There was no association between the total positive rate and sex. The detection rates by sex were: 39. 0% (588/1508) for male and 37.9% (373/984) for female,x~2=0.2962,P>0.05. The peak of RSV appeared from December to March. There was the highest RSV detection rate 50. 2% (164/327) with bronchiolitis. The hMPV can be detected all year around. The peak of hMPV appeared in winter and the detection rate was 13.2% (106/ 802). Conclusion RSV and hMPV are the main respiratory viral pathogens in Suzhou. Detection of viral pathogens in children with respiratory infection could give fast, accurate diagnostic evidenee, and help avoid antibiotics abuse.
