粤东地区毛细支气管炎病毒病原谱的变迁探究

目的探讨近年来粤东地区毛细支气管炎病毒病原学的构成现状。方法收集粤东地区2007年7月至2010年6月3年间毛细支气管炎患儿的咽拭子共508份，采用多重PCR方法检测呼吸道合胞病毒、腺病毒、流感病毒A型、流感病毒B型、副流感病毒1型、副流感病毒3型、鼻病毒、人类博卡病毒、人类偏肺病毒、WU多瘤病毒，共8种lO型病毒。结果①508例患儿中男374例（73．6％），女134例（26．4％）。②508例患儿中1岁以下年龄组393例（77．4％），病毒检出率为77．2％；1岁以上年龄组115例（22．6％），病毒检出率为22．8％。③2007年7至2008年6月病毒阳性率为47．5％（77／162），病毒检出第1位为呼吸道合胞病毒（33．7％），新发现呼吸道病毒（人类博卡病毒、人类偏肺病毒、wu多瘤病毒）占14．3％；2008年7月至2009年6月病毒阳性率为51．7％（124／240），病毒检出第1位为流感病毒A型（38．4％），新发现呼吸道病毒占6．4％；2009年7月至2010年6月病毒阳性率为45．3％（48／106），病毒检出第1位为鼻病毒（22．4％），新发现呼吸道病毒占20．9％。④3年间病毒混合感染率分别为20．8％、42．7％、27．1％。结论①毛细支气管炎患儿中男孩多见，1岁以下年龄组发病率及病毒检出率均高于1岁以上年龄组。②鼻病毒、流感病毒A型在不同年度是小儿毛细支气管炎首位病原体，既往研究中占首位的呼吸道合胞病毒有逐年下降趋势。③新发现呼吸道病毒在小儿毛细支气管炎病例中检出，并有逐年上升趋势。④毛细支气管炎病例中存在不同病毒混合感染的现象。

A study on transition of etiology in infants with bronchiolitis in eastern Guangdong

Objective To investigate the viral pathogen in children with bronchiolitis in eastern Guangdong. Methods Five hundred and eight swabs samples from children with bronchiolitis in eastern Guangdong were collected from July 2007 to Jun 2010. Multiplex PCR was applied to detect ten kinds of viruses including respiratory syncytial virus （RSV） ,adenovirus （ADV）, influenza virus A type （IFVA）, IFVB, parainfluenza virus type 1 （ PIV1 ）, PIV3, rhinovirus （Rhv）, human bocavirus （ HBoV）, human metapneumovirus （HMPV）, and WU polyomavirus （WUPyV）. Results 508 cases included 374 males （73.6%） and 134 females （26.4%）. 393 patients were less than one year old,and the positive rate of virus was 77.2%. 115 patients were older than one year old,the positive rate of virus was 22.8%. Positive rate of the respiratory viruses was 47.5% from July 2007 to June 2008, the first pathogen was RSV （33.6% ）, positive rate of newly identified respiratory viruses was 14.3 %. Positive rate of the respiratory viruses was 51.7% from July 2008 to June 2009,the first pathogen was IFVA （38.4%）,positive rate of newly identified respiratory viruses was 6.4%. Positive rate of the respiratory viruses was 45.3% from July 2009 to June 2010, the first pathogen was Rhv （22.4% ）, positive rate of newly identified respiratory viruses was 20.9%. The co-infection rate of three years were 20.8 G ,42.7 G, 27.1 %. Conclusions Boysare vulnerable to bronchiolitis than girls,mortality and positive rate of the respiratory viruses in children less than one year old is the highest. IFVA and Rhv have become the most common organisms instead of RSV, RSV has the tendency of drops year by year. The newly identified respiratory viruses are detected in bronchiolitis with increasing tendency year by year. Co-infection is common in bronehiolitis.