CAJ | 학술논문

目的了解近年上海地区呼吸道合胞病毒(RSV)、甲型和乙型流感病毒(IV-A和IV-B)、副流感病毒1、2、3型(PIV-1、2、3)以及腺病毒(ADV)在急性呼吸道感染住院儿童中的流行特征.方法回顾性分析2003-2006年连续4年复旦大学附属儿科医院收治入院的急性呼吸道感染儿童鼻咽吸取物7种常见呼吸道病毒的检出情况以及季节和年龄分布特点.直接免疫荧光法检测病毒.年龄分布比较作非参数检验.结果 4年期间共收集11214例患儿标本,其中98.7%取自急性下呼吸道感染,7种病毒总的阳性检出率为24.2%,其中RSV阳性率为17.7%,PIV-3为2.8%,ADV为2.2%,IV-A为0.7%,PIV-1为0.5%,PIV-2为0.3%,IV-B为0.1%,混合感染为0.2%.RSV通常在冬、春季流行,夏季很少检出,每2年RSV流行季节提前至秋季开始,持续流行较长时间.PIV-3、ADV和IV全年散发,某些月份时有流行.无固定的流行规律.病毒感染患儿年龄中位数RSV为4个月、PIV-3为8个月、PIV-1为9.5个月、PIV-2为10.5个月、ADV为12个月、IV为13个月,差异有统计学意义(X2154.319,P<0.01).RSV感染率随患儿年龄增长而降低,PIV-3在婴幼儿人群中感染率较高,ADV在1岁及以上儿童中感染率较高.结论 RSV是上海地区儿童呼吸道感染最常见的病毒病原,要幼儿易感,春、秋和冬季都有流行,PIV-3是第2位常见病原.感染儿童以婴幼儿常见,ADV是第3位常见病原,感染儿童年龄较大,IV检出率低,未出现ADV和IV在上海地区儿童中暴发流行.
목적 료해근년상해지구호흡도합포병독(RSV)、갑형화을형류감병독(IV-A화IV-B)、부류감병독1、2、3형(PIV-1、2、3)이급선병독(ADV)재급성호흡도감염주원인동중적류행특정.방법 회고성분석2003-2006년련속4년복단대학부속인과의원수치입원적급성호흡도감염인동비인흡취물7충상견호흡도병독적검출정황이급계절화년령분포특점.직접면역형광법검측병독.년령분포비교작비삼수검험.결과 4년기간공수집11214례환인표본,기중98.7%취자급성하호흡도감염,7충병독총적양성검출솔위24.2%,기중RSV양성솔위17.7%,PIV-3위2.8%,ADV위2.2%,IV-A위0.7%,PIV-1위0.5%,PIV-2위0.3%,IV-B위0.1%,혼합감염위0.2%.RSV통상재동、춘계류행,하계흔소검출,매2년RSV류행계절제전지추계개시,지속류행교장시간.PIV-3、ADV화IV전년산발,모사월빈시유류행.무고정적류행규률.병독감염환인년령중위수RSV위4개월、PIV-3위8개월、PIV-1위9.5개월、PIV-2위10.5개월、ADV위12개월、IV위13개월,차이유통계학의의(X2154.319,P<0.01).RSV감염솔수환인년령증장이강저,PIV-3재영유인인군중감염솔교고,ADV재1세급이상인동중감염솔교고.결론 RSV시상해지구인동호흡도감염최상견적병독병원,요유인역감,춘、추화동계도유류행,PIV-3시제2위상견병원.감염인동이영유인상견,ADV시제3위상견병원,감염인동년령교대,IV검출솔저,미출현ADV화IV재상해지구인동중폭발류행.
Objective To understand the epidemiology of respiratory syncytial virus(RSV),influenza virus type A and type B(IV-A and IV-B),parainfluenza virus type 1,2,3(PIV-1,2,3)and adenovirus(ADV) among children with acute respiratory tract infection in Shanghai.Methods A retrospective epidemiological investigation was conducted to analyze the prevalence rate,seasonality and susceptible pediatric population of seven common respiratory viruses among hospitalized pediatric patients(<15 years old) with acute respiratory tract infection in Children's Hospital Affiliate to Fudan University Shanghai during 2003 to 2006.Nasopharyngeal aspirates were collected for detecting viral antigens of RSV,IV-A,IV-B,PIV-1,PIV-2,PIV-3 and ADV by direct immunofluorescence assay.Results Total 11214 children were collected during the consecutive four years,among whom 98.7% were presented with acute lower respiratory tract infection.The overall positive detection rate of these seven respiratory viruses was 24.2%.RSV accounted for 17.7%,followed by PIV-3(2.8%),ADV(2.2%),IV-A(0.7%),PIV-I(0.5%),PIV-2(0.3%),IV-B(0.1%)and mixed(0.2%).RSV season often occurred in winter and spring,however,an early season began in autumn every two year.PIV-3,ADV and IV were usually prevalent sporadically and the seasonal patterns were not typical.The median ages of infected pediatric patients were 4 months for RSV,8 months for PIV-3,9.5 months for PIV-1,10.5 months for PIV-2,12 months for ADV,13 months for IV,respectively,which were significantly different by statistical analysis(X2=154.319,P<0.01).The infants and younger children were more susceptible for developing RSV and PIV-3 related diseases.RSV infection significantly decreased along with the age increased.Conclusions RSV is the most commonly identified virus,while infants and neonates are the most susceptible populations for RSV infection.Typically,RSV is prevalent during spring and winter but begins to be active in fall every other year. PIV-3 is found to be the second common viral pathogen and young children are susceptible population.ADV ranks the third pathogen and children with ADV infection tend to be elder. Nevertheless,IV is rare among pediatric population in recent years in Shanghai.In our study,the outbreaks of ADV and IV infections among children are not observed.