不同亚群呼吸道腺病毒在感染儿童中的流行特征及炎症反应的差异

目的 分析不同亚群呼吸道腺病毒在感染儿童中的流行特征及炎症反应的差异,为儿童感染的治疗供科学依据。方法 以2016年10月-2018年9月攀枝花市第二人民医院儿科门诊HAdV呼吸道感染的儿童186名为研究对象。分离、培养呼吸道腺病毒,通过hexon、fiber PCR确定腺病毒的类型和种类,并分析不同亚群腺病毒的时间、性别、年龄分布,通过试剂盒测定血清中细胞因子水平。结果 175名(94.09%)患者鉴别出HAdV类型,C亚群(2型、1型、5型、6型)最常见,为34.86%。B亚群病毒在夏季和初秋的发病率较高,C亚群病毒全年流行,E亚群病毒仅在早春流行。C亚群病毒主要在1岁左右儿童中检出,而B、E亚群病毒主要在较大儿童中检出(F=12.074,P=0.003)。C亚群腺病毒感染患者的WBC计数显著高于B亚群和E亚群感染患者(F=5.215,P<0.05)。此外,血清中共检测到11种细胞因子,C亚群感染患者中G-CSF、IFN-γ、IL-6、TNF-α、MCP-1、MIP-1β、Eotaxin7种细胞因子水平显著升高(F＝8.236、4.968、7.130、18.757、7.155、6.077、5.070,P<0.05),IL-10水平显著降低(F＝6.362,P<0.05)。结论 不同亚群呼吸道腺病毒在感染儿童中的流行特征及炎症反应方面存在显著差异,其中C亚群腺病毒引起的炎症反应最强烈。

Differences on epidemic characteristics and inflammatory response in different subgroups of respiratory adenovirus infected children

Objective To analyze the epidemic characteristics and inflammatory responseof human adenovirus (HAdVs) infected children in different subgroups,in order to provide scientific reference for the treatment of respiratory infections in children. Methods A total of 186 children with HAdV respiratory infections in Pediatric Outpatient Department were enrolled in this study from October 2016 to September 2018.The respiratory adenovirus was isolated and cultured.The type of adenovirus was determined by hexon and fiber PCR.The time,sex and age distribution of different subgroups of adenovirus were analyzed.The serum cytokine levels were determined by kit. Results HAdV type was identified in 175(94.09%) patients,and C subgroup(type 2,1,5 and 6) was the most common (34.86%).The subgroup B virus had a high incidence in summer and early autumn,and the C subgroup virus was prevalent throughout the year,while the E subgroup virus was only prevalent in early spring.The C subgroup virus was mainly detected in children around 1 year old,while the B subgroup and E subgroup viruswere mainly detected in older children(F=12.074,P=0.003).The WBC count of patients with subgroup C adenovirus infection was significantly higher than that of patients with B subgroup and E subgroup (F=5.215,P<0.05).In addition,11 types of cytokines were detected in serum,and the levels of 7 types of cytokines,such as G-CSF,IFN-γ,IL-6,TNF-α,MCP-1,MIP-1β and Eotaxin,significantly elevatedin patients infected with C subgroup (F=8.236,4.968,7.130,18.757,7.155,6.077,5.070,P<0.05).However,the IL-10 level was significantly decreased in patients infected with C subgroup (F=6.362,P<0.05). Conclusions There are significant differences on the epidemic characteristics and inflammatory response in different subgroups of children with respiratory adenovirus infection.Moreover,the inflammatory response caused by adenovirus C is the strongest.