急性呼吸道感染门诊患者的临床特征和病毒谱分析

目的分析急性呼吸道感染门诊患者的临床特征和病毒谱,为患者的临床治疗提供依据。方法收集2015年1月~2016年12月具有急性呼吸道感染症状的门诊患者的临床资料,并采集患者的咽拭子样本。应用多重PCR方法检测15种呼吸道病毒,并利用实时荧光RT-PCR技术鉴别甲型流感病毒的3种常见亚型。结果 465例门诊患者中,呼吸道病毒阳性137例,检出率为29.5%(137/465),其中单一病毒感染94.2%(129/137),病毒共感染5.8%(8/137);单一病毒感染中,以流感病毒为主,其次为肠道;病毒共检出中以鼻病毒和季节性H3N2流感病毒共检出为主。临床特征显示,病毒阳性患者的部分临床症状比病毒阴性患者重,更容易出现高热、咽喉痛、乏力、鼻涕、痰液及呼吸急促等症状,且肺部异常多见。不同年龄段患者的感染率存在一定的差异,5岁患儿最高(50.0%),其次为≥60岁的老年人(38.6%)。结论呼吸道病毒是导致门诊患者发生急性呼吸道感染的常见原因,特别是婴幼儿和老年人,因此,加强呼吸道病毒的检测将有助于急性呼吸道感染患者的防治。

Clinical characteristics and etiologic spectrums of outpatients with acute respiratory infections

Objective To analyze clinical characteristics and etiologic spectrums of outpatients with acute respiratory infections(ARIs)for providing basis for clinical treatment of patients.Methods Clinical data and throat specimens of outpatients with ARIs were collected from Jan 2015 to Dec 2016.Their samples were detected for fifteen respiratory viruses by multiple polymerase chain reaction(PCR),and three subtypes of influenza A virus(FluA)were identified by real-time RT-PCR assay.Results Of 465 outpatients,137 cases were positive for respiratory viruses,and the total positive rate was 29.5%(137/465).The percentage of single virus infection was 94.2%(129/137),and mixed infection was 5.8%(8/137).FluA virus was most pathogens of single virus infection,followed by enterovirus(EV).The coinfection with RhV+sH3N2 was major for the mixed infection.Some of clinical symptoms from outpatients with positive viruses were more severe than that of cases with negative viruses,and the outpatients with positive viruses had easily high fever,sore throat,fatigue,nasal discharge,sputum,and shortness of breath and other symptoms,and abnormal lung. The positive rate was significantly different among different ages,the highest of positive rate was children less than five years old(50.0%),followed by the elderly over the age of 60(38.6%).Conclusion Respiratory virus is one common cause of outpatients with ARIs,especially young children and the elderly,therefore,the enhancement of respiratory virus detection will contribute to prevention and control of outpatients with ARIs.