小儿急性呼吸道感染3309例病毒抗原检测及分析

目的:了解长沙地区一年四季不同年龄组小儿急性呼吸道感染病毒病原学特点及流行病学情况.方法:采用直接免疫荧光法(DIF)对2015年1月1日~2015年12月30日3309例长沙市中心医院儿科住院的急性呼吸道感染患者鼻咽分泌物进行七项呼吸道病毒联合检测.结果:943例患儿检出至少一种病毒,长沙地区呼吸道感染总阳性率28.5%(943/3309),其中呼吸道合胞病毒(RSV)721例(21.7%)、副流感3(PIV3)75(2.3%)、腺病毒(ADA)52(1.6%)、流感病毒A(IFA)24(0.7%)、副流感1(PIV1)13(0.4%)、副流感2(PIV2)11(0.3%)、流感病毒B(IFB)7(0.2%);RSV和ADA混合感染25例,检出率0.8%,RSV和PIV3混合感染15例,检出率0.5%;呼吸道合胞病毒(RSV)占总阳性病毒株的76.5%(721/943),其它病毒病原呈散在分布;新生儿期(出生-28天)、婴儿期(28d-1岁)、幼儿期(1-3岁)、学龄前期(3-6岁)、学龄期(6岁-)各组病源联检阳性率分别为37.8%、33.8%、32.3%、9.6%、6.3%,各年龄组病毒感染率比较差异均具有显著性;各年龄组病毒感染中,RSV阳性构成比分别为89.4%、80.8%、67.5%、50%、33.3%,年龄组间比较差异有显著性.长沙地区呼吸道病毒感染有明显的季节性,不同月份阳性率不同,四季当中,春、冬季阳性率较高,夏、秋季阳性较低.结论:病毒是小儿急性呼吸道感染的主要病原,长沙地区各年龄组小儿急性呼吸道感染主要为病毒病原RSV,年龄越小发病率越高,混合感染以婴儿、幼儿为主,呼吸道病毒感染显季节流行.

Detection and analysis of virus antigen in 3309 cases children with acute respiratory tract infection

Objective To understand the etiologic characteristics and epidemio-logy of acute respiratory infection in chil-dren in different age groups in Changsha area. Methods Nasopharyngeal secretions of 3309 cases of acute respiratory tract in-fection pediatric patients from January 1, 2015 to December 30, 2015 in Central Hospital of Changsha were detected by direct immunofluorescence (DIF) in seven respiratory virus detection, and the results were analyzed by x2 test with SPSS17.0. Results 943 cases were positive with at least one of the seven viruses, and the total positive rate is 28.5%(943/3309); and the positive cases was shown to be respiratory syncytial virus (RSV) 721 patients (21.7%), parainfluenza 3 (PIV3) 75 (2.3%), adenovirus (ADA) 52 (1.6%), influenza virus A (IFA) 24 (0.7%), parainfluenza 1 (PIV1) 13 (0.4%), parainfluenza 2 (PIV2) 11 (0.3%) and influenza virus B (IFB) 7 (0.2%); 25 cases were RSV and ADA mixed infection with the detection rate of 0.8%; 15 cases were RSV and PIV3 mixed infection with the detection rate of 0.5%; positive rate of respiratory virus (RSV) was 76.5% (721/943), other viral pathogens are scattered in the distribution; Neonatal period (birth to 28 days), infancy (28d-1 years), early child-hood (1-3 years), preschool children (3-6 years old), school (6 years old-), and the positive rate of the above pathogen groups was respectively for 37.8%, 33.8%, 32.3%, 9.6% and 6.3%. of differences of viruses infection rate in each age groups are sig-nificant; In all age groups, RSV positive ratio was 89.4%, 80.8%, 67.5%, 50%, 33.3% respectively, the differences between the age groups were also significant. There are obvious seasonal differences in respiratory tract virus infection in Changsha area. The positive rate was different in different months. The positive rate was higher in spring and winter and lower in summer and autumn. Conclusion Children acute respiratory infection in Changsha area is mainly by RSV, the younger the age, the higher incidence rate in children, mixed infection occured mainly in infants and young children. Respiratory tract virus infection trans-mission was related to the factor of season.