CAJ | 학술논문

目的了解A、B、C各基因型人鼻病毒(HRV)感染所致儿童急性呼吸道感染(ARI)的临床类型.方法收集2011年1月至2012年12月首都儿科研究所附属儿童医院门诊或住院的ARI患儿呼吸道标本1412例,采用半巢式PCR方法进行HRV检测,HRV阳性者经序列测定确定基因型别,并对各基因型检测阳性的病例进行临床类型分析.结果 1412例标本中有103例HRV检测阳性(7.3％),序列分析表明,103例中54例为HRV-A(52.4％),14例为HRV-B(13.6％),35例为HRV-C(34.0％)；在下呼吸道感染(LRI)的儿童中,HRV各基因型阳性检出率均高于上呼吸道感染(URI)的儿童(P值分别为0.003、0.011、0.003)；在LRI中,HRV-A、HRV-C的阳性检出率均高于HRV-B(P=0.000,0.026),而HRV-A、C则相近(P =0.112)；HRV各基因型检出率在不同严重程度ARI中的分布差异无统计学意义(Hc=0.044,P＞0.05,Kruskal-Wallis H检验)；HRV与其他病毒的混合感染与单一HRV感染的检出率相比较,在不同严重程度ARI中的分布差异亦无统计学意义(Zc=0.872,P＞0.05,Wilcoxon秩和检验).结论 HRV是引起北京地区儿童急性呼吸道感染(尤其是LRI)重要的病毒病原之一；HRV-C阳性检出率与HRV-A相近,较HRV-B高；尚不能认为HRV-A、B、C不同基因型感染引起的ARI存在严重程度的差别；其他病毒与HRV的混合感染未显著增加ARI的严重程度.
목적 료해A、B、C각기인형인비병독(HRV)감염소치인동급성호흡도감염(ARI)적림상류형.방법 수집2011년1월지2012년12월수도인과연구소부속인동의원문진혹주원적ARI환인호흡도표본1412례,채용반소식PCR방법진행HRV검측,HRV양성자경서렬측정학정기인형별,병대각기인형검측양성적병례진행림상류형분석.결과 1412례표본중유103례HRV검측양성(7.3％),서렬분석표명,103례중54례위HRV-A(52.4％),14례위HRV-B(13.6％),35례위HRV-C(34.0％)；재하호흡도감염(LRI)적인동중,HRV각기인형양성검출솔균고우상호흡도감염(URI)적인동(P치분별위0.003、0.011、0.003)；재LRI중,HRV-A、HRV-C적양성검출솔균고우HRV-B(P=0.000,0.026),이HRV-A、C칙상근(P =0.112)；HRV각기인형검출솔재불동엄중정도ARI중적분포차이무통계학의의(Hc=0.044,P＞0.05,Kruskal-Wallis H검험)；HRV여기타병독적혼합감염여단일HRV감염적검출솔상비교,재불동엄중정도ARI중적분포차이역무통계학의의(Zc=0.872,P＞0.05,Wilcoxon질화검험).결론 HRV시인기북경지구인동급성호흡도감염(우기시LRI)중요적병독병원지일；HRV-C양성검출솔여HRV-A상근,교HRV-B고；상불능인위HRV-A、B、C불동기인형감염인기적ARI존재엄중정도적차별；기타병독여HRV적혼합감염미현저증가ARI적엄중정도.
Objective To understand the clinical characteristics of different groups human rhinovirus (HRV)-A,B and C infection in children with acute respiratory tract infections (ARI) in Beijing.Method Respiratory tract specimens (n =1412) collected from children with ARI during Jan.2011 to Dec.2012 were tested for HRV by using semi-nested PCR.Gene fragments of VP4/VP2 capsid protein amplified from HRV positive specimens were sequenced for HRV genotype confirmation.Then epidemiological characteristics of these HRV-positive cases were analyzed.Result Among these 1412 specimens tested,103 (7.3％) were HRV positive,including 54 (52.4％) positive for HRV-A,14 (13.6％) for HRV-B,35 (34.0％) for HRV-C determined by sequence analysis.The positive rates of HRV-A,B and C (2.5％,16/638; 0.3％,2/638 and 1.3％,8/638) in children with acute upper respiratory tract infections(URI) were lower than those(5.8％,36/623 ; 1.8％,11/623 and 3.9％,24/ 623) in children with acute lower respiratory tract infections (LRI) (P =0.003,0.011,0.003).In children with LRI,the positive rates of HRV-A,C were similar to each other(P =0.112),and both were higher than that of HRV-B(P =0.000,P =0.026).The severity of ARI among children positive for different groups HRV showed no significant difference evaluated by Kruskal-Wallis H test(Hc =0.044,P ＞ 0.05),as well as that between children co-infected with HRV and other viruses and those infected with HRV only evaluated by Wilcoxon rank sum test (Zc =0.872,P ＞ 0.05).Conclusion HRV is one of important pathogens for children with ARI,especially LRI in Beijing.The positive rates of HRV-A and HRV-C are similar to each other,and both are higher than that of HRV-B.No significant difference was shown among children with different HRV genotypes by evaluation of the severity of ARI,and co-infections of HRV with other viruses do not significantly increase the severity of ARI.