2001年至2008年苏州地区儿童急性呼吸道感染中腺病毒感染的流行趋势

目的了解近8年来苏州地区儿童急性呼吸道感染中腺病毒（ADV）的感染流行趋势。方法用直接免疫荧光（DFA）法对2001年1月至2008年12月共22607份急性呼吸道感染患儿鼻咽分泌物标本进行ADV等7种呼吸道病毒抗原检测;用酶联免疫吸附法（ELISA）对145例确诊ADV感染患儿血清进行肺炎支原体（MP）、肺炎衣原体（CP）抗体定量测定;同时用逆转录-聚合酶链反应（RT-PCR）对上述145例ADV感染患儿鼻咽分泌物标本进行人类偏肺病毒（hMPV）RNA抗原定性测定。结果 （1）22607份标本中共检出ADV312份,阳性检出率为1.38%;2001—2008年ADV全年阳性检出率依次为2.72%、0.88%、1.13%、1.19%、0.99%、1.53%、0.79%和1.47%。（2）自2006年起的145例ADV感染患儿同时检出MP感染47例（32.41%）,同时检出hMPV感染6例（4.14%）,未检出ADV与CP混合感染;312例ADV患儿同时检出流感病毒B型2例（0.64%）,同时检出呼吸道合胞病毒1例（0.32%）,未检出ADV与流感病毒A型及副流感病毒的混合感染。（3）ADV感染四季均可发生,相对高发季节在每年的4～8月份;3岁以上儿童阳性检出率显著高于3岁以下儿童,差异有高度统计学意义（P﹤0.01）。（4）ADV所致疾病分布：3岁以上儿童以咽扁桃体炎高发（P﹤0.01）,3岁以内儿童以下呼吸道感染高发（P﹤0.01）。结论苏州地区儿童ADV检出率不高,感染相对高峰季节为每年的春夏季;3～8岁儿童为ADV高发年龄。

Adeno Virus Infection in Pediatric Patients with Acute Respiratory Infections in Suzhou Area During 2001-2008

Objective To investigate the infectious features of adeno virus（ ADV） in pediatric patients with acute respiratory infection and the relationship of ADV infection with other pathogens in recent eight years. Methods Direct immunofluorescence assay （ DFA） was used to identify ADV from nasophoryngeal secrtion specimen,which were taken from 22 607 patients with acute respiratory infection; mycoplasma pneumoniae （ MP） and chlamydia pneumoniae （ CP） were detected and quantified with ELISA from the serum ,RT-PCR assay was employed to detect the RNA of Human Metapneumovirus （ hMPV） from the nasophoryngeal secrtion specimen. Results （ 1） Three hundred and twelve specimens were confirmed to be positive of ADV infection in 22 607 specimens,the total positive rate was 1. 38% ; the annual positive rate of ADV was 2. 72%,0. 88%,1. 13%,1. 19%,0. 99%,1. 53%,0. 79% and 1. 47% from 2001 to 2008. （ 2） One hundred and forty-five patients who were infected by ADV were enrolled into the detection of MP 、CP and hMPV from 2006. There were 47 positive cases of MP infection （ 32. 41% ） ,only 6 positive cases of hMPV（ 4. 14% ） and no cases were infected by CP; in the survey of the total 312 ADV positive specimen,there was just 2 patients of the influenza B positive and 1 patient of the Parainfluenza virus,no mix infection with RSV and influenza A. （ 3） ADV infection could occur in any seasons. There was a higher possibility of ADV infection from April to August in every year; according to the age, there was an unbalance distribution in different age groups,the group which was older than 3 years old had a higher positive rate of ADV infection than that in another group（ P 0. 01） . （ 4） The diease which was caused by ADV infection had a different exhibition in different age group. There was a higher incidence of Pharyngeal tonsil in patients who were older than 3 years old （ P 0. 01） ,and there were a higher incidence of lower respiratory tract infection in the other（ P 0. 01） . Conclusion There is a low positive rate of ADV infection in Suzhou,and the infection is concentrated in Spring and Summer annually; the patients who were above 3 years were a preference group of ADV infection,the intergrowth can exist in ADV and MP,but ADV can not coexistent with other respiratory viruses,this phenomenon needs futher study.