2665例急性上呼吸道感染患儿的病原学及临床特征

目的 分析急性上呼吸道感染儿童患者的病原学及临床特征。方法 以南方医科大学珠江医院2009年11月至2015年9月收治的2 665例急性上呼吸道感染儿童为研究对象,采用qRT-PCR方法检测临床上常见的8种呼吸道病毒(流感病毒、呼吸道合胞病毒、副流感病毒、腺病毒、人类博卡病毒、人类冠状病毒、人类偏肺病毒、鼻病毒)。结果 共检测患儿标本2 665份,其中阳性标本1 566份,总阳性率为58.8%。四个季节中8种呼吸道病毒检出率存在明显差异,并以春季最高,夏冬季次之,秋季最低。儿童呼吸道病毒感染率随着年龄增加而逐渐降低,并以0~1岁婴幼儿病毒检出率最高64.5%。男童呼吸道病毒感染率高于女童,住院患儿呼吸道病毒检出率高于门诊患儿。混合感染标本260份,占阳性标本数的16.6%,主要集中于0~3岁儿童患者标本中,并因季节而异,秋冬季节较少,而春夏季节较为普遍。咳嗽为呼吸道病毒感染的主要临床症状,咳痰和流涕次之,临床症状在8种呼吸道病毒感染患儿中存在差异。结论 本调查分析了急性上呼吸道感染患儿中8种常见呼吸道病毒的病原学及临床特征,为指导临床治疗及防控提供相关数据。

Study on the etiological and clinical characteristics from 2 665 children with acute upper respiratory tract infections

This study aimed to evaluate the etiological and clinical characteristics of acute upper respiratory tract infections in children from GuangZhou, China. A total of 2 665 nose swabs specimen collected from children with acute upper respiratory tract infections from Zhujiang Hospital, Southern Medical University, Guangzhou, China during November 2009 to September 2015 were enrolled in this study. There were 1 566 virus positive responses were detected in samples from 2665 child patients with acute upper respiratory infections, with the positive rate of 58.8%. The positive rates were 22.5% for respiratory sycytial virus (RSV), 13.0% for rhinovirus (HRV), 9.0% for influenza virus (FLU), 7.6% for parainfluenza virus (PIV), 6.1% for adenovirus (AdV), 4.0% for human metapneumovirus (HMPV), 3.7% for human coronavirus (HCOV), 3.5% for human Bocavirus (HBOV). There was statistical significant in the detection rates of 8 respiratory viruses in different seasons, with the highest in spring, followed by summer and winter, and lowest in autumn. The respiratory virus infection rate of children gradually decreased with age, with a positive detection rate of 67.0% between children aged 0-3 years. And the respiratory virus detection rate of boys was significantly higher than that of girls. The co-infection rates were higher in child patients aged 0-3 years, and were higher during spring and summer than that of autumn and winter. Cough is the main clinical symptom of acute upper respiratory virus infection, followed by sputum and runny nose. The clinical symptoms are different in children between 8 respiratory virus infections. This study increases our knowledge of the etiological and clinical characteristics of these 8 common respiratory viruses among children with respiratory tract infections. Which might also provide relevant data to guide clinical treatment and prevention.