摘要:
目的 了解人偏肺病毒和博卡病毒在肺炎住院儿童中的分子流行及临床特征.方法 2017年11月至2018年5月收集因社区获得性肺炎在承德医学院第二临床学院儿科住院儿童的咽拭子标本333份,并收集患者的临床信息.血清学检测腺病毒,呼吸道合胞病毒,流感病毒,副流感病毒的IgM抗体,RT-PCR或PCR检测人偏肺病毒,人博卡病毒,腺病毒,呼吸道合胞病毒和人冠状病毒.结果 血清学检测显示43例患者为乙型流感病毒IgM阳性、19例患者为副流感病毒IgM阳性、3例患者为呼吸道合胞病毒IgM阳性、2例患者为腺病毒IgM阳性.PCR或RT-PCR结果 显示80例患者为人偏肺病毒感染(其中71例为单独感染、8例为共感染、1例为三重感染)、22例患者为人博卡病毒感染(其中14例为单独感染、7例为共感染、1例为三重感染)、6例患者为腺病毒感染(其中4例为单独感染、1例为共感染、1例为三重感染)、呼吸道合胞病毒和人冠状病毒感染患者各1例且为单独感染.80例人偏肺病毒感染患者中5岁以下患者为39例(11.7%)、5岁以上患者为41例(12.3%).重症组病毒阳性率为45.0%(18/40),轻症组病毒阳性率为27.99%(82/293),重症组病毒阳性率高于轻症组(P=0.042).重症患者在年龄(P=0.000)、发热高峰(P=0.035)、住院时间(P=0.000)、中性粒细胞比例(P=0.000)和淋巴细胞比例(P=0.000)与轻症患者相比有显著差异.结论 多种呼吸道病毒感染可引起社区获得性肺炎、应加强对人偏肺病毒和人博卡病毒的流行监测.%Objective To study the molecular prevalence and clinical characteristics of human metapneumovirus and human bocavirus in hospitalized children with community-acquired pneumonia. Methods Total 333 throat swabs and clinical information of patients were collected between 2017 and 2018at Department of Pediatrics of No. 2 Clinical Teaching Hospital, Chengde Medical University. The IgM of adenovirus ( AdV ) , respiratory syncytial virus ( RSV ) , influenza virus-A/B ( Influ-A/B ) , parainfluenza viruses ( PIVs) were tested by detection kit, and the positive samples of human metapneumovirus ( hMPV) , human bocavirus ( HBoV) , AdV, RSV and human coronavirus ( HCoV) were detected by RT-PCR or PCR. Results 43 cases, 19 cases, 3 cases and 2 cases were positive for Influ-B, PIV, RSV and AdV IgM, respectively. Total 80 cases were infected with hMPV (71 cases were single infection, 8 cases were double infection, and 1 case was triple infection ) , 22 cases were infected with HBoV ( 14 cases were single infection, 7 cases were double infection, and 1 case was triple infection) , 6 cases were infected with AdV (4 cases were single infection, 1 case was double infection, and 1 case was triple infection), only 1 case was single infected with RSV or HCoV, respectively. 39 cases ( 11. 7%) and 41 cases ( 12. 3%) were distributed at <5 years group and ≥5 years group, respectively. 45. 0%( 18/40 ) in severe cases and 27. 99%(82/293)in mild cases were positive for hMPV, HBoV, AdV, RSV and HCoV, the ratio of viral positive case was significant higher in severe cases than mild cases ( P=0. 042 ) . The age ( P=0. 000 ) , peak of fever ( P = 0. 035 ) , duration of hospitalization ( P = 0. 000 ) , neutrophils ( P = 0. 000 ) and lymphocytes ( P=0. 000) were significant difference in severe cases compared with mild cases. Conclusions Multiple respiratory viruses can cause community-acquired pneumonia and more attention should be pay to the surveillance of hMPV and HBoV.