中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2015年
9期
707-711
,共5页
钱艺%谢正德%任丽丽%刘春艳%肖艳%徐保平%杨燕%钱素云%耿荣
錢藝%謝正德%任麗麗%劉春豔%肖豔%徐保平%楊燕%錢素雲%耿榮
전예%사정덕%임려려%류춘염%초염%서보평%양연%전소운%경영
冠状病毒%呼吸道感染%儿童
冠狀病毒%呼吸道感染%兒童
관상병독%호흡도감염%인동
Coronavirus%Respiratory tract infection%Child
目的 了解北京地区儿童急性下呼吸道感染(ALRTI)中人冠状病毒(HCoV)的感染情况,了解儿童急性下呼吸道HCoV感染的临床特征.方法 2007年3月至2015年2月首都医科大学附属北京儿童医院内科急救室就诊及住院的急性下呼吸道感染患儿共4 371例,按年龄分为4组,其中＜1岁组1 890例;1～＜3岁组788例;3～＜6岁组553例;≥6岁组1 140例.采用RT-PCR方法,对患儿鼻咽吸取物进行HCoV(包括HCoV-OC43,HCoV-229E,HCoV-NL63和HCoV-HKU1)及RSV等9种常见呼吸道病毒检测.对单纯HCoV阳性住院病例的临床表现进行分析,并与同期单纯呼吸道合胞病毒感染住院病例的临床特征进行对比.结果 (1)在总共4 371例ALRTI患儿中,病毒阳性2 895例(66.23％),其中HCoV阳性147例(检出率3.36％).(2)2007-2014年各年份HCoV的检出率(％)分别为:6.11、3.79、4.69、4.31、2.38、2.10、0.77和2.65;1-12月各月HCoV的检出率(％)依次为2.53、2.12、3.63、6.68、1.53、3.77、3.92、3.00、2.15、5.26、3.叭和2.80.(3)不同种HCoV在4 371例ALRTI患儿中的检出情况如下:HCoV-OC43阳性48例(1.10％),HCoV-229E阳性32例(0.73％),HCoV-NL63阳性25例(0.57％),HCoV-HKU1阳性27例(0.62％).(4)＜1岁、1～＜3岁、3～＜6岁和≥6岁年龄组HCoV的检出率分别为4.13％、5.08％、2.71％和1.23％(x2 =27.218,P＜0.01).(5)单纯HCoV急性下呼吸道感染住院患儿共16例,其中支气管肺炎12例,急性喉梗阻3例,支气管哮喘急性发作2例.常见临床表现为咳嗽(14例)、喘息(13例)、呼吸困难(9例)、发热(6例)、声嘶(4例)、喉鸣(4例),胸X线片异常(包括肺纹理增粗模糊、斑片影或致密影)(12例).其临床表现、并发症的发生率以及接受机械通气的比例,与同期193例单纯RSV感染患儿差异无统计学意义.结论 2007年3月至2015年2月北京地区HCoV检出率为3.36％;单纯HCoV急性下呼吸道感染住院患儿临床表现及病情严重程度与单纯呼吸道合胞病毒感染者相似.
目的 瞭解北京地區兒童急性下呼吸道感染(ALRTI)中人冠狀病毒(HCoV)的感染情況,瞭解兒童急性下呼吸道HCoV感染的臨床特徵.方法 2007年3月至2015年2月首都醫科大學附屬北京兒童醫院內科急救室就診及住院的急性下呼吸道感染患兒共4 371例,按年齡分為4組,其中＜1歲組1 890例;1～＜3歲組788例;3～＜6歲組553例;≥6歲組1 140例.採用RT-PCR方法,對患兒鼻嚥吸取物進行HCoV(包括HCoV-OC43,HCoV-229E,HCoV-NL63和HCoV-HKU1)及RSV等9種常見呼吸道病毒檢測.對單純HCoV暘性住院病例的臨床錶現進行分析,併與同期單純呼吸道閤胞病毒感染住院病例的臨床特徵進行對比.結果 (1)在總共4 371例ALRTI患兒中,病毒暘性2 895例(66.23％),其中HCoV暘性147例(檢齣率3.36％).(2)2007-2014年各年份HCoV的檢齣率(％)分彆為:6.11、3.79、4.69、4.31、2.38、2.10、0.77和2.65;1-12月各月HCoV的檢齣率(％)依次為2.53、2.12、3.63、6.68、1.53、3.77、3.92、3.00、2.15、5.26、3.叭和2.80.(3)不同種HCoV在4 371例ALRTI患兒中的檢齣情況如下:HCoV-OC43暘性48例(1.10％),HCoV-229E暘性32例(0.73％),HCoV-NL63暘性25例(0.57％),HCoV-HKU1暘性27例(0.62％).(4)＜1歲、1～＜3歲、3～＜6歲和≥6歲年齡組HCoV的檢齣率分彆為4.13％、5.08％、2.71％和1.23％(x2 =27.218,P＜0.01).(5)單純HCoV急性下呼吸道感染住院患兒共16例,其中支氣管肺炎12例,急性喉梗阻3例,支氣管哮喘急性髮作2例.常見臨床錶現為咳嗽(14例)、喘息(13例)、呼吸睏難(9例)、髮熱(6例)、聲嘶(4例)、喉鳴(4例),胸X線片異常(包括肺紋理增粗模糊、斑片影或緻密影)(12例).其臨床錶現、併髮癥的髮生率以及接受機械通氣的比例,與同期193例單純RSV感染患兒差異無統計學意義.結論 2007年3月至2015年2月北京地區HCoV檢齣率為3.36％;單純HCoV急性下呼吸道感染住院患兒臨床錶現及病情嚴重程度與單純呼吸道閤胞病毒感染者相似.
목적 료해북경지구인동급성하호흡도감염(ALRTI)중인관상병독(HCoV)적감염정황,료해인동급성하호흡도HCoV감염적림상특정.방법 2007년3월지2015년2월수도의과대학부속북경인동의원내과급구실취진급주원적급성하호흡도감염환인공4 371례,안년령분위4조,기중＜1세조1 890례;1～＜3세조788례;3～＜6세조553례;≥6세조1 140례.채용RT-PCR방법,대환인비인흡취물진행HCoV(포괄HCoV-OC43,HCoV-229E,HCoV-NL63화HCoV-HKU1)급RSV등9충상견호흡도병독검측.대단순HCoV양성주원병례적림상표현진행분석,병여동기단순호흡도합포병독감염주원병례적림상특정진행대비.결과 (1)재총공4 371례ALRTI환인중,병독양성2 895례(66.23％),기중HCoV양성147례(검출솔3.36％).(2)2007-2014년각년빈HCoV적검출솔(％)분별위:6.11、3.79、4.69、4.31、2.38、2.10、0.77화2.65;1-12월각월HCoV적검출솔(％)의차위2.53、2.12、3.63、6.68、1.53、3.77、3.92、3.00、2.15、5.26、3.팔화2.80.(3)불동충HCoV재4 371례ALRTI환인중적검출정황여하:HCoV-OC43양성48례(1.10％),HCoV-229E양성32례(0.73％),HCoV-NL63양성25례(0.57％),HCoV-HKU1양성27례(0.62％).(4)＜1세、1～＜3세、3～＜6세화≥6세년령조HCoV적검출솔분별위4.13％、5.08％、2.71％화1.23％(x2 =27.218,P＜0.01).(5)단순HCoV급성하호흡도감염주원환인공16례,기중지기관폐염12례,급성후경조3례,지기관효천급성발작2례.상견림상표현위해수(14례)、천식(13례)、호흡곤난(9례)、발열(6례)、성시(4례)、후명(4례),흉X선편이상(포괄폐문리증조모호、반편영혹치밀영)(12례).기림상표현、병발증적발생솔이급접수궤계통기적비례,여동기193례단순RSV감염환인차이무통계학의의.결론 2007년3월지2015년2월북경지구HCoV검출솔위3.36％;단순HCoV급성하호흡도감염주원환인림상표현급병정엄중정도여단순호흡도합포병독감염자상사.
Objective To investigate human coronaviruses (HCoVs) infection in children with acute lower respiratory tract infection (ALRTI) and to explore the clinical features of ALRTI caused by HCoVs in children.Method Totally 4 371 children with clinical diagnosis of ALRTI during the period from March 2007 to February 2015 seen in Beijing Children's Hospital were recruited into this study.Patients were divided into 4 groups by age,including 1 890 cases in ＜ 1 year group,788 cases in 1-3 years group,553 cases in 3-6 years group,1140 cases in ≥6 years group.One nasopharyngeal aspirate specimen was collected from each patient.RT-PCR methods were applied to detect 9 common respiratory viruses including HCoVs (including HCoV-OC43,HCoV-229E,HCoV-NL63 and HCoV-HKU1),respiratory syncytial virus (RSV) and so on.Clinical features of ALRTI with single HCoVs infection were analyzed and compared with hospitalized ALRTI cases with single RSV infection in the same period.Result (1) Totally 2 895 cases were positive for at least one virus in this study in 4 371 ALRTI patients (positive rate 66.23％),in which 147 cases were positive for HCoVs infection (positive rate 3.36％).(2) Positive rates of HCoVs in each year from 2007 to 2014 were 6.11％,3.79％,4.69％,4.31％,2.38％ 2.10％,0.77％ and 2.65％,respectively.The mean positive rates of HCoVs for each month from January to December were 2.53％,2.12％,3.63％,6.68％,1.53％,3.77％,3.92％,3.00％,2.15％,5.26％,3.01％ and 2.80％.(3) Detection results of each subtypes of HCoVs in total 4 371 pediatric ALRTI patients were:48 cases positive for HCoV-OC43 (1.10％),32 cases positive for HCoV-229E (0.73％),25 cases positive for HCoV-NL63(0.57％),27 cases positive for HCoV-HKU1 (0.62％).(4) Positive rates of HCoVs infection in ＜ 1 year group,1-3 years group,3-6 years group and≥6 years group were 4.13％,5.08％,2.71％ and 1.23％,respectively.There were significant differences in positive rates of HCoV among groups (x2 =27.218,P ＜0.01).(5) There were 16 hospitalized cases with single infection of HCoVs in this study,of which 12 cases were diagnosed as bronchopneumonia,3 cases developed acute laryngeal obstruction,2 cases had acute bronchial asthma attack.Common clinical manifestations included cough (14 cases),gasping (13 cases),dyspnea (9 cases),fever (6 cases),hoarseness (4 cases),laryngeal stridor (4 cases) and abnormality on chest X-ray(including fuzzy lung texture,patchy shadow and consolidation) (12 cases).(6) There were no significant differences in the incidence of clinical manifestations (including cough,gasping,dyspnea,fever and abnormality on chest X-ray),complications (including respiratory failure,myocardial damage,and acute bronchial asthma attack) and mechanical ventilation between hospitalized ALRTI patients with single HCoV infection and 193 patients with single RSV infection in the same period.Conclusion HCoVs are pathogens of ALRTI in children,The overall positive rate of HCoVs was 3.36％ in this study.The clinical manifestations and severity of ALRTI caused by single HCoVs was comparable to that of ALRTI with single RSV infection in children.
