中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2013年
4期
255-259
,共5页
刘春艳%肖艳%谢正德%任丽丽%胡英惠%幺远%杨燕%钱素云%赵成松
劉春豔%肖豔%謝正德%任麗麗%鬍英惠%幺遠%楊燕%錢素雲%趙成鬆
류춘염%초염%사정덕%임려려%호영혜%요원%양연%전소운%조성송
呼吸道感染%儿童%病毒
呼吸道感染%兒童%病毒
호흡도감염%인동%병독
Respiratory tract infections%Child%Virus
目的 了解同期门诊和住院儿童急性呼吸道感染的病毒病原特点及流行特征.方法 2010年3月至2012年2月首都医科大学附属北京儿童医院门诊及住院的临床诊断为急性呼吸道感染的患儿共2066例.其中门诊病例1050例,住院病例1016例.每例患儿采集咽拭子或鼻咽吸取物标本1份,采用逆转录聚合酶链反应(RT-PCR)方法进行呼吸道病毒核酸检测,包括呼吸道合胞病毒、鼻病毒、副流感病毒1～4型、流感病毒、腺病毒、肠道病毒、冠状病毒、偏肺病毒及博卡病毒.结果 本组病例中,1274例检出至少1种病毒,总的病毒检出率为61.7％,住院患儿检出率(69.7％)高于门诊患儿(53.9％) (x2 =54.394,P＜0.001).呼吸道合胞病毒是住院急性呼吸道感染患儿最主要病原,其次是鼻病毒、副流感病毒；流感病毒在门诊病例检出率最高,其次是腺病毒、副流感病毒.377例检出2种或2种以上病毒,住院患儿混合感染率(30.1％)高于门诊患儿(6.8％)(x2=188.820,P ＜0.001).结论 门诊患儿流感病毒检出率最高,而呼吸道合胞病毒是住院患儿中最常检出的病毒.多种病毒混合感染在急性呼吸道感染儿童较常见,特别是住院病例,但其临床意义还有待进一步研究.
目的 瞭解同期門診和住院兒童急性呼吸道感染的病毒病原特點及流行特徵.方法 2010年3月至2012年2月首都醫科大學附屬北京兒童醫院門診及住院的臨床診斷為急性呼吸道感染的患兒共2066例.其中門診病例1050例,住院病例1016例.每例患兒採集嚥拭子或鼻嚥吸取物標本1份,採用逆轉錄聚閤酶鏈反應(RT-PCR)方法進行呼吸道病毒覈痠檢測,包括呼吸道閤胞病毒、鼻病毒、副流感病毒1～4型、流感病毒、腺病毒、腸道病毒、冠狀病毒、偏肺病毒及博卡病毒.結果 本組病例中,1274例檢齣至少1種病毒,總的病毒檢齣率為61.7％,住院患兒檢齣率(69.7％)高于門診患兒(53.9％) (x2 =54.394,P＜0.001).呼吸道閤胞病毒是住院急性呼吸道感染患兒最主要病原,其次是鼻病毒、副流感病毒；流感病毒在門診病例檢齣率最高,其次是腺病毒、副流感病毒.377例檢齣2種或2種以上病毒,住院患兒混閤感染率(30.1％)高于門診患兒(6.8％)(x2=188.820,P ＜0.001).結論 門診患兒流感病毒檢齣率最高,而呼吸道閤胞病毒是住院患兒中最常檢齣的病毒.多種病毒混閤感染在急性呼吸道感染兒童較常見,特彆是住院病例,但其臨床意義還有待進一步研究.
목적 료해동기문진화주원인동급성호흡도감염적병독병원특점급류행특정.방법 2010년3월지2012년2월수도의과대학부속북경인동의원문진급주원적림상진단위급성호흡도감염적환인공2066례.기중문진병례1050례,주원병례1016례.매례환인채집인식자혹비인흡취물표본1빈,채용역전록취합매련반응(RT-PCR)방법진행호흡도병독핵산검측,포괄호흡도합포병독、비병독、부류감병독1～4형、류감병독、선병독、장도병독、관상병독、편폐병독급박잡병독.결과 본조병례중,1274례검출지소1충병독,총적병독검출솔위61.7％,주원환인검출솔(69.7％)고우문진환인(53.9％) (x2 =54.394,P＜0.001).호흡도합포병독시주원급성호흡도감염환인최주요병원,기차시비병독、부류감병독；류감병독재문진병례검출솔최고,기차시선병독、부류감병독.377례검출2충혹2충이상병독,주원환인혼합감염솔(30.1％)고우문진환인(6.8％)(x2=188.820,P ＜0.001).결론 문진환인류감병독검출솔최고,이호흡도합포병독시주원환인중최상검출적병독.다충병독혼합감염재급성호흡도감염인동교상견,특별시주원병례,단기림상의의환유대진일보연구.
Objective Acute respiratory tract infections (ARI) are the leading cause of pediatric morbidity and mortality worldwide,particularly in developing countries.Viruses are the main pathogens of ARI in children.The purpose of the present study was to determine the epidemiologic features of respiratory viruses,including novel viruses,in outpatient and hospitalized children with ARI.Method From March 2010 to February 2012,2066 children with ARI,including 1050 outpatients and 1016 inpatients,were involved in this study.One nasopharyngeal aspirate or throat swab specimen was collected from each patient.Reverse transcription (RT) PCRs were performed to detect common respiratory tract viruses including respiratory syncytial virus (RSV),human rhinovirus (HRV),influenza virus (IFV),parainfluenza virus (PIV) type 1-4,adenovirus (ADV),enterovirus (EV),human coronavirus (HCOV),human metapneumonia virus (HMPV) and human bocavirus (HBOV).Result At least one viral pathogen was identified in each of 1274 out of 2066 patients and the overall positive rate was 61.7％.The positive rate in inpatient (69.7％) was higher than that in outpatient (53.9％).The frequencies of detection of various viruses among in-and outpatients were different.RSV was the most prevalent virus detected among hospitalized children,followed by HRV and PIV,whereas IFV was the most frequently identified virus in the outpatient group,followed by ADV and PIV.Simultaneous detection of two or more viruses was found in 377 cases.Coinfection was more frequent in inpatients than in outpatients (30.1％ vs.6.8％,P ＜ 0.001).Conclusion Respiratory viruses play an important role in children with ARI,especially in young children.RSV was the most prevalent virus detected among hospitalized children,whereas IFV was the most frequently identified virus in the outpatient group.Viral coinfections are frequently identified,particularly in hospitalized patients.Further studies are required to better understand the impact of coinfections in children with ARI.
