粤东地区喘息性疾病患儿中人偏肺病毒的检出与病原学初步研究

目的 了解人类偏肺病毒(hMPV)在粤东地区的感染情况与小儿感染的临床特征.方法 采用逆转录-聚合酶链式反应法(RT-PCR)对粤东地区喘息性疾病儿童和健康体检儿童共323例的鼻咽抽吸物及咽拭子进行hMPV基因筛查,然后随机挑选6份RT-PCR扩增阳性产物进行纯化测序,将测序结果与Genbank中的多株hMPV N蛋白基因序列进行比较和进化树分析.分析hMPV感染患儿的临床资料.结果 240份小儿喘息性疾病呼吸道标本中,检测到hMPV病毒阳性12例(阳性率5%),3、4月份为发病高峰.阳性均为年龄较小患儿.6份hMPV阳性标本目标基因部分核苷酸序列与GenBank中公布的多株hMPV N基因同源性达80.8%～98.4%.核苷酸序列基因进化树分析显示存在2种不同的基因型.12例hMPV阳性患儿均表现咳嗽、低热、及喘息等临床症状;临床诊断为毛细支气管炎8例、喘息型肺炎4例.83份健康体检儿童的呼吸道标本中均未检测到hMPV特异性基因片段.结论 hMPV是粤东地区婴幼儿喘息性疾病的重要病毒性病原体之一.粤东地区流行的hMPV株存在2种不同的基因型.     

人类偏肺病毒研究进展

研究表明,婴幼儿急性呼吸道感染（acute respiratory infection,ARI）的主要病原是人类呼吸道合胞病毒（hRSV）、流感病毒（甲、乙型）、副流感病毒（主要是Ⅰ、Ⅲ型）、肠道病毒和腺病毒,还有一部分病原尚未明了。     

急性喘息性疾病患儿呼吸道病毒感染特点

目的 调查急性喘息性疾病患儿的呼吸道病毒感染特点.方法 163例急性喘息性疾病患儿,采用RT-PCR方法对患儿鼻咽分泌物进行呼吸道病毒包括呼吸道合胞病毒(RSV)、鼻病毒(HRV)、偏肺病毒(hMPV)、流感病毒A、B型、副流感病毒Ⅰ、Ⅱ、Ⅲ和腺病毒的检测,检出的阳性病例入选,分析其与年龄、季节、喘息史及疾病类型的相关性.结果 163例份标本中检出呼吸道病毒阳性132例份,阳性检出率为80.9％,其中RSV单独感染、HRV单独感染及RSV+ HRV混合感染检出率分别为37.4％、25.1％及12.9％.≤1岁儿童RSV感染检出率为58.3％,1～3岁儿童HRV感染检出率为32.8％;冬春季RSV病毒阳性检出率分别为45.6％、50.8％,HRV病毒阳性检出率分别为31.7％、26.2％;有喘息史儿童RSV感染检出率为46.1％,无喘息史儿童HRV感染检出率为39.3％;毛细支气管炎及喘息性支气管炎儿童RSV病毒感染检出率分别为48.1％、33.3％,婴幼儿哮喘儿童HRV感染检出率为35.2％.结论 急性喘息性疾病患儿的呼吸道病毒感染率高.RSV是儿童急性喘息性疾病的首位病毒,其次是HRV.≤1岁儿童主要为RSV感染,1～3岁儿童主要为HRV感染;冬春季RSV及HRV病毒阳性率检出较高;无喘息史儿童更易被RSV病毒感染,有喘息史儿童则易被HRV感染;毛细支气管炎及喘息性支气管炎儿童更易被RSV病毒单独感染,婴幼儿哮喘儿童则更易被HRV单独感染.     

人偏肺病毒与呼吸道合胞病毒感染后细胞因子改变的比较

人偏肺病毒与呼吸道合胞病毒是呼吸道感染的常见病原体,其感染后的发病机制尚不完全清楚,广泛接受的假说是引起机体固有免疫反应.大量研究显示两者产生不同的细胞因子效应,也提示人偏肺病毒感染的发病机制可能有别于呼吸道合胞病毒.本文就目前国内外对人偏肺病毒感染后与呼吸道合胞病毒细胞因子改变的比较研究进行综述.     

聊城地区1998年小儿呼吸道感染病毒病原学检测

为明确聊城地区小儿呼吸道感染病毒种类，我院采用单克隆抗体快速检测技术，对１５９例感染患儿的鼻咽部脱落细胞进行４类６种呼吸道病毒抗原快速检测。现报告如下。１临床资料１．１一般情况检测患儿１５９例，其中住院患儿４３例（男２５例，女１８例；年龄≤４岁３６例...     

小儿呼吸道衣原体感染与喘息性疾病的关系

衣原体是一类有独特发育周期，严格细胞内寄生的原核细胞型微生物，大致分为4类：沙眼衣原体(chlamydia trachomatis，CTr)、肺炎衣原体(chlamydia pneumoniae，CPn)、鹦鹉热衣原体(chlamydia psittaci，CPs)、牲畜衣原体(chlamydia pecorum，CPe)，前两是引起小儿呼吸系统感染的常见病原体。自从确定衣原体为人类致病菌以来，     

人偏肺病毒引起老年人严重呼吸道感染性疾病爆发

据Medscape．com 5月3日报道（原载Clin Infect Dis 2007；44：1152—1160），在一个长期健康保护中心发现，人偏肺病毒（Metapneumovius，hMPV）可能与老年人爆发流行严重的呼吸道感染疾病有关。[第一段]     

也门儿童的人麦塔肺病毒和呼吸道合胞病毒

发展中国家中能够增加呼吸道感染严重性的因素很少被关注。我们报道的因素与发生在也门儿童的严重的呼吸系统疾病有关（266位呼吸合胞病毒感染和66位人麦塔肺病毒感染）．年龄．室内空气污染和不完全接种疫苗是危险因素．这不同于发达国家．     

人类偏肺病毒与呼吸道合胞病毒呼吸道感染的临床研究

目的 了解福州地区人类偏肺病毒(HMPV)感染情况,比较HMPV与呼吸道合胞病毒(RSV)引起呼吸道感染的临床特征及流行特点.方法 采集2005年至2007年连续两个冬春季节153份福建省立医院就诊呼吸道感染患者痰标本或咽拭子标本,RT-PCR和套式RT-PCR分别检测RSV和HMPV,部分阳性PCR产物测序,DNAMAN软件分析;结合临床资料,比较两种病毒所引起的呼吸道感染临床症状、体征和流行特点.结果 153份鼻咽分泌物标本中,32份HMPV阳性,阳性率为20.9%;26份RSV阳性,阳性率为17.0%,8份HMPV和RSV均阳性.随机抽取3份标本,HMPV核苷酸序列一致,登载NCBI基因库(序列号DQ887758),基因进化树分析为单一基因型,属A基因型,但发生部分变异.2005年至2006年冬春HMPV阳性26份,阳性率为26.7%,2006年至2007年冬春HMPV阳性6份,阳性率为10.7%,而RSV检出情况与HMPV相反.儿童RSV感染平均年龄为(2.65±2.65)岁,HMPV为(4.58±3.35)岁.两种病毒引起呼吸道感染症状均以咳嗽、咽痛,发热为主.结论 HMPV与RSV均是福州地区冬春季节呼吸道病毒感染的主要病原体,两者可合并感染;HMPV主要感染年龄较大儿童,HMPV与RSV的临床特征相似.本研究期间福州地区发现的HMPV为单一基因型.     

Milk-induced wheezing in children with asthma

BackgroundFood allergy has been gaining increasing attention, mostly as causing gastrointestinal and cutaneous reactions. Its role in asthma seems to be under-recognised.ObjectivesThis study's aim is to explore the frequency of involvement of a common food, namely cow's milk, in childhood asthma.Methods32 children (5 months to 11 years; median 24 months; mean 34 months) with asthma and a suspected history of cow's milk allergy were studied. They underwent skin prick testing (SPT) and specific IgE (sIgE) testing to whole cow's milk (WCM), casein, α-lactalbumin, and β-lactoglobulin, followed by single-blind oral milk challenge.ResultsReactions to milk challenge occurred in 12 (37.5%) including wheezing in 5 (41.7%, or 15.6% of the whole group). Children who developed wheezing at the time of challenge were younger than those who had negative challenge (23.0 months vs. 34.8 months). Challenge was positive in 33.3% of subjects who had a positive SPT, and SPT was positive in 50% of challenge-positive subjects. Regarding sIgE, challenge was positive in 26.7% of sIgE-positive subjects, and sIgE was positive in 33.3% of challenge positive subjects. Skin or serum testing with individual protein fractions did not seem to add significant advantage over testing with WCM alone.ConclusionThis study shows that cow's milk can cause wheezing in children with asthma. Although SPT seemed to be more reliable than sIgE testing, both had suboptimal reliability. It is worth considering possible milk allergy in children with asthma, particularly when poorly controlled in spite of proper routine management.     

Asthma exacerbations in children associated with rhinovirus but not human metapneumovirus infection

Children with asthma were studied during the Southern hemisphere winter and summer of 2001-2002. Human rhinovirus (hRV) was significantly associated (P=.0001) with asthma exacerbations in winter and spring/summer, but not in intervening asymptomatic periods. Although hRV was also found in children with upper respiratory tract infection (URTI) who underwent sampling at the same time, it was present in significantly higher numbers of children with symptomatic asthma (P<.0001). Human metapneumovirus was also found in small numbers of children with URTI, but significantly less frequently in children with asthma.     

High seroprevalence of human metapneumovirus among young children in Israel

Exposure to the newly discovered human metapneumovirus (HMPV) during the first 2 years of life was studied by longitudinal serological analysis in 40 healthy children in southern Israel. The seropositivity rate decreased to a minimum by age 13 months and increased to 52% by age 24 months. Evidence of new infection was detected in 13%, 23%, and 55% of children by ages 7, 13, and 24 months, respectively. The high exposure rates suggest that HMPV may be an important cause of community-acquired respiratory-tract infections in young children.     

Prevalence of human Metapneumovirus (hMPV) in children with wheezing in Shiraz-Iran

Human metapneumovirus (hMPV) infection plays an important role in the pediatric respiratory infections. The aim of this study was to determine the relationship between asthma and wheezing with hMPV in hospitalized children. Nasal pharyngeal swabs obtained from 120 children aged 1-60 months, hospitalized during a one year period, were tested for the hMPV by RT-PCR. HMPV was detected in 20 (16.6%) of patients suffering from wheezing. Some patients in addition to wheezing had asthma 10.8%. This infection occurred predominantly from October 2008 to September 2009.