2009-2010年苏州地区博卡病毒感染住院患儿临床特征分析

摘要

Objective To Investigate the epidemiology and clinical features of human bocavirus ( HBoV) infection in patients with acute respiratory infections in Suzhou area. Methods The sputum was collected from 3 826 in patients with acute respiratory infections from January 2009 to December 2010. DNA of HBoV was tested by real-time PCR, while the respiratory syneytial virus (RSV) , influenza virus A and B, parainfluenza virus (I - HI ) , and adenovirus were measured by direct immunofluoresoence. Meanwhile, the RNA of human metapneumovirus was tested by reverse-transcription PCR and mycoplasma by quantitative fluorescent PCR and culture. The clinical features and epidemiology of patients with HBoV infection were analyzed and compared with those of RSV infection. Results Of the 3 816 patients screened, 272 (7.13%) patients were indicative of HBoV infection, which was the second most common viral pathogen than RSV infection. In 32.7% of the cases, HBoV was the only pathogen. The rate of co-infection of HBoV and other respiratory viruses was 18.38% which was higher than that of RSV (P < 0.05). HBoV infection could occur all the year around but most seen in summer. The most detection rate (48.17%) happened in patients aged from 6 to 18 months. The percentage of bronchopneumonia caused by HBoV infection were 85.52% and the main clinical features included cough (96.63%) , wheezing (46.07% ) and fever (56.18%). White blood cell, the ratio of neutrophils to WBCs, C-reactive protein were higher in HBoV positive patients than in RSV positive patients (P < 0.05). Conculsions HBoV is one of the most important viral pathogens in children with respiratory infection in Suzhou area. Infection can be caused by HBoV only. The occurrences of age and season, clinical feature and laboratory data of HBoV infection are significantly difference from of RSV infection.%目的 探讨苏州地区因急性呼吸道感染住院患儿中人类博卡病毒(human bocavirus,HBoV)感染的临床特征.方法 收集2009年1月-2010年12月因急性呼吸道感染住院的3 826例患儿的痰标本,应用实时PCR检测HBoV DNA,直接免疫荧光法检测呼吸道合胞病毒、流感病毒(A、B)、副流感病毒(1～3)和腺病毒,同时采用逆转录PCR检测人偏肺病毒RNA,并进行细菌培养及荧光定量PCR检测支原体DNA,分析HBoV感染的临床特点及流行病学特征,并与呼吸道合胞病毒( RSV)进行比较.结果 3 816份标本共检测到HBoV 272例(7.13％),仅次于RSV; HBoV单独感染率为32.7％,与其他呼吸道病毒的合并感染率为18.38％,高于RSV和其他病毒的合并感染率(P＜0.05).HBoV感染全年均有发生,夏季最多；6～18月龄婴幼儿检出率最高,占48.17％.在住院患儿中,HBoV主要引起支气管肺炎(85.39％),临床症状主要表现为咳嗽(96.63％)、喘息(46.07％)、发热(56.18％).与RSV相比,HBoV感染患儿的白细胞、中性粒细胞比例、CRP均高于RSV,差异有统计学意义(P＜0.05).结论 HBoV是苏州地区小儿呼吸道感染的重要病原体之一,有单独的致病性,与RSV相比,在年龄、季节分布、临床症状、实验室指标等方面有明显差异.