七种呼吸道病毒抗原检测在儿童呼吸道感染中的分析

摘要

目的 了解广东清远地区儿童呼吸道病毒感染情况,为儿童呼吸道病毒感染的诊断提供依据.方法 收集我院2014年2月-2015年1月住院的呼吸道疾病患儿5121例,采用直接免疫荧光法对其鼻咽部分泌物进行流感病毒 (influenza virus, IF)A、IFB、 副流感病毒 (parainfluenza virus, PIV)1、PIV2、PIV3、呼吸道合胞病毒(respiratory syncytial virus, RSV)以及腺病毒(adenovirus, ADV)进行抗原检测, 并对数据进行统计学分析. 结果 5121例呼吸道感染患儿中检出呼吸道病毒1801例, 阳性率为35.17%. 其中,RSV为937例(52.03%)、IFA为312例(17.32%)、ADV为209例(11.60%)、PIV3为186例(10.33%)、PIV1 为 60 例(3.33%)、IFB 为 38 例(2.11%)、PIV2 为 5 例(0.28%)、混合感染为 54 例(3.00%).男、女感染呼吸道病毒患儿的阳性率经比较,差异无统计学意义(P>0.05).≤1岁和2~3岁患儿感染病毒的阳性率均高于4~5岁、6~7岁和8~12岁患儿, 且各组间比较差异有统计学意义 (P均<0.05).≤1岁和2~3岁患儿感染RSV的阳性率最高(61.84%,44.99%),其余三组患儿感染ADV的阳性率最高(44.52%,36.84%,53.49%). 5121例患儿在春季感染病毒的阳性率高于夏、秋、冬季,经比较差异有统计学意义(P<0.05),其中春、夏、秋季均以感染RSV的阳性率最高(52.26%,73.61%,33.12%),冬季以感染ADV的阳性率最高(23.34%).5121例患儿中,患急性气管炎的患儿感染病毒的阳性率高于患上呼吸道感染、肺炎和支气管炎的患儿,经比较差异有统计学意义(P<0.05),其中上呼吸道感染、急性气管炎和肺炎患儿感染RSV的阳性率最高(66.53%,38.81%,61.25%),支气管炎患儿感染IFA的阳性率最高(37.58%).54例混合感染患儿中,以感染RSV的患儿最多(26例).结论 RSV是清远地区儿童呼吸道病毒感染的主要病原体,3岁以下儿童呼吸道病毒感染率最高,春季为呼吸道病毒感染高发季节.%Objective To investigate the epidemic situation of children with respiratory viruses in Qingyuan, Guangdong. And to provide evidence for the diagnosis of respiratory virus infections in children. Methods 5121 inpatients with respiratory disease were collected in our hospital from February 2014 to Jan-uary 2015. Influenza virus (IF)A, IFB, parainfluenza virus (PIV)1, PIV2, PIV3, respiratory syncytial virus (RSV) and adenovirus (ADV) were detected by direct immunofluorescent. All data were analyzed statistical significance. Results There were 1801 cases (35.17%) were viral positive in 5121 patients. Among the posi-tive cases, there were 937 cases in RSV(52.03%), 312 cases in IFA(17.32%), 209 cases in ADV(11.60%), 186 cases in PIV3(10.33%), 60 cases in PIV1(3.33%), 38 cases in IFB(2.11%), 5 cases in PIV2(0.28%) and 54 cases in mixed infection(3.00%). Postitive rates of respiratory viruses in male and female had no statis-tical significance(P>0.05). Positive rates of patients between≤1 age and 2~3 age were all higher than that of 4~5 age, 6~7 age and 8~12 age patients, and the differences had statistical significance (Pall<0.05). The highest positive rate of respiratory viruses in≤1 age and 2~3 age patients was RSV(61.84%,44.99%), and in other three groups was ADV (44.52%,36.84%,53.49%). The highest positive rate of respiratory viurses was in spring, which compared with summer, autumn and winter had statistical significance (P<0.05). The highest positive rate of respiratory viruses in spring, summer and autumn was RSV(52.26%,73.61%,33.12%), and in winter was ADV (23.34%). The positive rate of patients with acute tracheitis was higher than that of patients with upper respiratory infection, pneumonia and bronchitis, and the differences had statistical significance (P< 0.05). The highest positive rate of respiratory viruses in upper respiratory infection, acute tracheitis and pneumonia was RSV(66.53%,38.81%,61.25%), and in bronchitis was IFA(37.58%). In 54 patients with mixed infection, the most cases was patients with RSV (26 cases). Conclusion Spring is the high incidence of res-piratory virus infection in children in Qingyuan. The infection rate of children under 3 years old is the highest. The main pathogen is RSV.