2000年冬-2006年春北京地区急性呼吸道感染患儿中呼吸道合胞病毒的监测

目的 对北京急性呼吸道感染患儿进行呼吸道合胞病毒（RSV）的监测并进行亚型分析,探讨其流行规律。方法 2000年11月-2006年3月,于首都儿科研究所附属儿童医院采集因急性呼吸道感染就诊的门诊及住院的患儿咽拭子或鼻咽分泌物标本10048份,接种于Hep-2细胞进行病毒分离,同时用免疫荧光法对鼻咽分泌物标本进行呼吸道病毒抗原的快速检测,对部分RSV阳性的标本用RT-PCR进行了亚型鉴定。结果 （1）在10048份标本中,有2286份为RSV阳性,阳性检出率为22．8％。其中病房标本7176份,RSV阳性2153份,阳性检出率为30．0％;门诊标本2872份,RSV阳性133份,阳性检出率为4．6％。（2）2000～2001年冬春、2002-2003年冬春、2004-2005年冬春RSV的阳性检出率分别为14．0％、18．2％和20．4％,而2001—2002年冬春、2003—2004年冬春和2005-2006年冬春RSV的阳性检出率分别为42．3％、41．0％和40．5％。（3）对938份RSV阳性标本的亚型监测结果：A亚型691份,占73．7％,B亚型247份,占26．3％,2000-2001、2004-2005年冬春季RSV感染以B亚型为主;而2001-2002、2002-2003、2003-2004年冬春季以A亚型为主;2005—2006年为A、B亚型同时流行。结论 RSV是冬春季婴幼儿下呼吸道感染的主要病毒病原,RSV呈现出隔年高峰的流行趋势,RSVA、B亚型是交替出现的,并且有时以相近的比例同时出现。     

1978—1996年广州地区呼吸道合胞病毒感染分析

为了解广州地区儿童呼吸道合胞病毒（ＲＳＶ）感染的情况，采用病毒分离等方法，对广州地区１９７８～１９９６年连续１８年的儿童支气管炎和支气管肺炎进行了ＲＳＶ病原学检测。共检测患儿５２７３例，分离出ＲＳＶ的患儿５１３例。病毒分离总阳性率９．７％。１８年中以１９８５年、１９８６年和１９９２年ＲＳＶ分离率最高；一年中ＲＳＶ分离率从３月份开始增高，４月份达高峰，持续至５～８月，９月份开始下降。结论：１８年来广州地区有过３次ＲＳＶ感染流行高峰（１９８５年、１９８６年、１９９２年）；广州地区ＲＳＶ感染的流行季节主要发生在每年的春夏季。     

呼吸道合胞病毒感染的防治

呼吸道合胞病毒（ｒｅｓｐｉｒａｔｏｒｙ ｓｙｎｃｙｔｉａｌ ｖｉｒｕｓ，ＲＳＶ）属副粘病毒科，肺炎病毒属。１９５６年Ｍｏｒｒｉｓ从一只有“感冒”症状的实验动物黑猩猩的鼻咽分泌物中分离出第一株。１９５７年Ｃｈａｎｏｃｋ先后从ＢＡＬＴＩＭＯＲＥ市两名分别患肺炎和有喘息症状患儿的咽拭子中分离到。因其在组织培养中能形成特殊的细胞融合病变而得名。ＲＳＶ是婴幼儿下呼吸道感杂的最主要病原体，２～６个月发病率最高。早产、先天性心脏病、肺发育不良等是致危的主要因素。ＲＳＶ感染不仅可诱发哮喘，而且与病情的加重有关。 …     

急性下呼吸道感染住院患儿呼吸道合胞病毒感染分析

目的了解急性下呼吸道感染（acutelowerrespiratoryinfection,ALRI）住院患儿呼吸道合胞病毒（respiratorysyncytialviruS,RSV）感染的情况。方法对2010年1月至2013年3月2625例ALRJ住院患儿采用直接免疫荧光法检测其鼻咽分泌物中的RSV抗原。结果送检标本2625例,RSV阳性534例（20．34％）。〈1岁组RSV阳性检出率24．30％（399／1642）,一3岁组15．83％（114／720）,〉3岁组7．98％（21／263）,〈1岁与～3岁组比较（x2=21．102,P〈0．01）,-3岁与〉3岁组比较（X2=10．016,P〈0．01）,差异均有统计学意义。男性患儿RSV阳性检出率21．49％（331／1540）,女性18．71％（203／1085）,男性检出率高于女性（x2=4．579,P〈0．05）。不同年度RSV阳性检出率差异无统计学意义。RSV检出率高峰从每年的10月开始,至次年的4月结束。结论ALRI住院患儿RSV阳性检出率以1岁以内婴儿最高,年龄越小,RSV感染率越高,男性RSV感染高于女性,冬春季为流行高峰。     

婴儿呼吸道合胞病毒感染与儿童哮喘

呼吸道合胞病毒 (RSV)是婴儿喘息性下呼吸道感染最常见的病原 ,婴儿期严重RSV感染是以后发生儿童哮喘的高危因素。动物哮喘模型实验表明致敏前后RSV感染都可加重气道高反应性。RSV感染与哮喘相关性的机制涉及对变应原致敏作用的增强、生后早期RSV感染诱导辅助性T细胞 2反应及与特应性的协同作用、神经免疫性炎症等     

呼吸道合胞病毒感染的基因治疗研究进展

基因治疗是一种新的治疗手段，它通过改变或修饰宿主基因以达到治疗疾病的目的，目前，基因治疗已经被广泛应用于多种疾病，如遗传性疾病、肿瘤及微生物感染等的治疗，本文就呼吸道合胞病毒感染的基因治疗研究进展进行简要综述。     

呼吸道合胞病毒感染流行病学研究

我们于 1992年 1月～ 2 0 0 1年 12月对在我科住院确诊为支气管肺炎[1] 的住院患儿检测了血清呼吸道合胞病毒(ＲＳＶ)特异性抗体及鼻咽部柱状上皮细胞中ＲＳＶ特异性抗原 ,现报告如下。材料和方法一、对象　采集支气管肺炎急性期和恢复期双相血清测ＲＳＶ抗体滴度 12 3例 ,采集急性期单相血清测ＲＳＶＩｇＭ抗体 2 79例 ,采集急性期鼻咽部分泌物查柱状上皮细胞内ＲＳＶ抗原 875例。三种方法共检测 12 77例。其中男 715例 ,女5 6 2例 ,年龄 10ｄ～ 14岁 ,≤ 6个月 330例 ,～ 1岁 2 49例 ,～ 2岁 2 30例 ,～ 3岁 12 4例 ,～ 14岁 34 4例。二、…     

呼吸道合胞病毒感染的基因治疗研究进展

基因治疗是一种新的治疗手段，它通过改变或修饰宿主基因以达到治疗疾病的目的。目前，基因治疗已经被广泛应用于多种疾病，如遗传性疾病、肿瘤及微生物感染等的治疗，本文主要就呼吸道合胞病毒感染的基因治疗进展进行简要综述。     

呼吸道合胞病毒感染与其特异性IgG的关系

采用ELISA法检测99例急性毛细支气管炎病儿鼻咽分泌物中呼吸道台胞病毒（RSV）、腺病毒（AdV）3、7和副流感病毒（PIV）1、3抗原以及血清RSV－SIgG滴度。结果三种病毒阳性总检出率为65.7％，RSV为主要病原，其次是AdV3、7和PIVI、3。32／36例RSV感染病儿血清RSV－sIgG滴度≤1：100，明显低于健康新生儿、健康儿童和成年人水平。血清RSV－SIgG滴度较低的病儿临床表现较重，病程也较长，但未见统计学差异。提示血清RSV－sIgG水平低下可能是RSV致病的重要因素。     

呼吸道合胞病毒感染的实验诊断

呼吸道合胞病毒(RSV)是引起婴幼儿急性呼吸道感染的重要病原之一,在探索RSV感染的实验诊断方面国外作了大量的前瞻性研究。 病毒分离及方法的改良 自1957年Chanock等在2名患有呼吸道感染儿童的咽拭子标本中首次分离到RSV后,病毒分离一直仍是诊断RSV感染的传统有效的方法,并为血清学和免疫学检查奠定了基础。Hall等发现RSV易受外界环境的影响,常温下容易灭活,故提出了床边接种法,并证明床边接种法比非床边接种法可明     

急性呼吸道感染儿童两亚型呼吸道合胞病毒检测分析

目的 了解2006-2007年度重庆地区住院急性呼吸道感染(ARTIs)儿童两亚型呼吸道合胞病毒(RSV)的感染特点及流行规律.方法 收集2006年4月至2007年3月全年在重庆医科大学附属儿童医院呼吸科住院的部分ARTIs患儿的鼻咽深部吸取物390份,针对RSV G基因保守区序列设计分型引物,采用RT-PCR方法检测标本中RSV的基因组RNA.结果 390例标本中RSV阳性例数为133例(133/390,阳性率为34.10%).阳性标本中A亚型阳性129例,B亚型阳性4例.RSV阳性患儿中,84.9%为2岁以下小儿.2006年11月～2007年1月为RSV高发季节,RSV检测阳性率为55.6%～62.3%,2006年12月RSV检测阳性率最高.B亚型出现于本地区RSV感染低发季节(4、5、6月).RSV感染的临床表现主要为发热(56.4%)、咳嗽(98.5%)、喘息(63.9%)、气促(76.7%)、紫绀(84.9%).临床诊断依次为毛细支气管炎(33.1%),支气管肺炎(27.8%),间质性肺炎(18.1%),重症肺炎伴呼吸衰竭(10.5%),喘息性支气管炎(5.3%),支气管哮喘(4.5%).结论 本研究初步阐明了重庆地区两亚型RSV感染的流行病学特点,证实RSV是重庆地区冬春季婴幼儿ARI的重要病原,2006-2007年度以A亚型RSV流行为主.今后的研究将纳入门诊及社区惠儿并进行多年度连续监测以进一步阐明重庆地区两亚型RSV流行规律及病毒进化特点.     

双黄连雾化吸入治疗呼吸道合胞病毒所致急性下呼吸道感染

为评价双黄连雾化吸入对呼吸道合胞病毒（RSV）所致急性下呼吸道感染的疗效，采用双盲随机对照方法对45例3岁以下有RSV感染的肺炎或毛细支气管炎病例进行了治疗研究。双黄连组17例，病毒哩组和对照组各14例。结果表明，治疗后双黄连组及病毒唑组在症状体征缓解天数方面均短于对照组（F=5.12，P＜0．01）；血氧分压的改善双黄连组显著高于其他两组（F=4.31，P＜0．05）；肺部X线检查结果双黄连组也短于其他两组（H=11.01，P＜0．01）。双黄连组病毒检出率较低，细胞免疫指标恢复正常者亦较其他两组多。双黄连组未见任何严重副作用。研究结果提示，双黄连雾化吸入治疗RSV引起的下呼吸道感染是安全有效的方法。     

International variation in the management of infants hospitalized with respiratory syncytial virus

Respiratory syncytial virus (RSV) is a frequent cause of hospitalization among infants. To compare patient management in Europe, the United States, and Australia, we analyzed the charts of 1,563 pediatric patients hospitalized with laboratory-confirmed RSV lower respiratory infections during recent RSV seasons. Half of patients had been seen initially as outpatients. Median duration of hospitalization was 4 days in Australia, Finland, the United Kingdom, and the United States, and 8 or 9 days in Belgium, France, Germany, Italy, and the Netherlands. In a linear regression model that included clinical findings, underlying conditions, prematurity, and age, the leading variable associated with length of stay was “hospitalization in continental Europe”. This geographic factor conferred a 1.8-fold longer stay (95% CI: 1.7–1.9) than hospitalization elsewhere. Utilization of nine supportive therapies for RSV varied widely among hospitals, even within the same country. The individual hospital was strongly associated with the use of every therapy studied, independent of patient characteristics and clinical status. Conclusion Management of RSV patients varies markedly by country and hospital. Multicenter RSV trials that measure length of stay should standardize criteria for “readiness for discharge”. It may be appropriate to limit international trials to countries with similar median stays for RSV. Variability within multicenter trials could be further controlled by standardizing the use of other therapies and the diagnosis of complications. Received: 29 April 1997 / Accepted in revised form: 11 August 1997     

Burden of respiratory syncytial virus infection in young children

Respiratory syncytial virus (RSV) is the most frequent and important cause of lower respiratory tract infection in infants and children. It is a seasonal virus, with peak rates of infection occurring annually in the cold season in temperate climates, and in the rainy season, as temperatures fall, in tropical climates. High risk groups for severe RSV disease include infants below six mo of age, premature infants with or without chronic lung disease, infants with hemodynamically significant congenital heart disease, infants with immunodeficiency or cystic fibrosis, and infants with neuromuscular diseases. Mortality rates associated with RSV infection are generally low in previous healthy infants (below 1%), but increase significantly in children with underlying chronic conditions and comorbidities. Following early RSV lower respiratory tract infection, some patients experience recurrent episodes of wheezing mimicking early childhood asthma with persistence of lung function abnormalities until adolescence. There is currently no RSV vaccine available, but promising candidate vaccines are in development. Palivizumab, a monoclonal RSV antibody that is the only tool for immunoprophylaxis in high-risk infants, lowers the burden of RSV infection in certain carefully selected patient groups.     

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??Objective To investigate the clinical relevance of multiple viral infections in children with acute lower respiratory disease. Methods A total of 1722 children with clinical diagnosis of lower respiratory tract infection ??ALRTI?? during the period of October 2007 to September 2011 were involved in our study. One nasopharyngeal aspirate specimen was collected from each patient. ??RT?? PCRs were performed to detect common respiratory tract viruses including respiratory syncytial virus ??RSV?? ?? rhinovirus ??RV?? ?? influenza virus type A and B?? parainfluenza virus ??PIV?? type 1-4?? adenovirus ??enterovirus?? human coronavirus?? human metapneumonia virus and human bocavirus. Results Totally 206 children had single RSV infection?? 124 children had dual infections ??RSV co-infected with an additional virus?? and 40 children had multiple infections along with a RSV infection. Out of the 124 patients?? 68??54.8%?? were co-infected with RV?? 24 with PIV. There was a statistically significant difference between the dual viral infections group and the RSV-infected group in hospital stay??P??0.001??. Compared to patients in the single RSV infected group?? patients in the multiple viral infection group had significantly more frequency in fever ??P??0.017???? duration of fever longer??P??0.015???? hospital stay also longer??P??0.001????and they received more intravenous steroid therapy during hospitalization??P??0.005??. There was no significant difference in oxygen therapy?? respiratory support and use of bronchodilators. Conclusion Multiple viral infections are linked to more frequency in fever?? longer fever days?? longer hospital stay?? and more frequent use of intravenous steroid therapy during hospitalization. Mixed respiratory virus infection may affect the patient's disease severity and prognosis.     

Respiratory syncytial virus infection in lower respiratory tract and asthma attack in hospitalized children in North Hokkaido,Japan

Respiratory syncytial virus (RSV) infection is severe and life-threatening in some infants. To investigate the epidemiology of RSV infection in hospitalized children in North Hokkaido, Japan, we tried to detect RSV antigen in nasopharyngeal aspirates (NPA) from those children with lower respiratory tract infection (LRTI) and asthma attack. From April 1991 to March 1992, 317 patients were hospitalized in our pediatric ward for the treatment of LRTI and asthma attack. The presence of RSV antigen in NPA taken from 283 patients (89.3%) were examined by enzyme immunoassay. RSV antigen was detected in 88 patients (31.1%). RSV LRTI were noted throughout the year, and the epidemic peak was observed in November and December. There was no significant correlation between the RSV antigen positive rate and mean temperature. RSV played an important role in LTRI in children in North Hokkaido, Japan. RSV LRTI in North Hokkaido was not rare in summer, indicating that RSV was transmitted commonly among children throughout the year.