2009-2011年重庆地区儿童呼吸道病毒感染流行特征分析

Epidemiological characteristics of children’s respiratory tract viral infection in Chongqing during 2009 and 2011

摘要:

目的：比较重庆地区住院儿童常见呼吸道病毒感染的流行特征及致病情况。方法：回顾性分析2009-2011年共19 452例呼吸科住院患儿，采用直接免疫荧光法检测出患儿鼻咽分泌物中的7种常见呼吸道病毒，包括呼吸道合胞病毒（respiratory syncytial virus，RSV）、腺病毒（adenovirus，ADV）、流感病毒A（influenza virus A，IVA）、流感病毒B（influenza virus B，IVB）及副流感病毒（parainfluenza virus，PIV）；回顾性分析住院患儿流行病学资料及2009年病毒致病情况。结果：（1）各病毒阳性率分别为RSV 29.23%、ADV 3.98%、IVA 2.54%、IVB 0.47%、PIV1 1.94%、PIV2 0.25%、PIV3 9.83%。（2）RSV感染高峰在每年12月、1月，其次为11月、2月。PIV3及ADV感染在4~7月多见。（3）不同性别（?字2=75.014，P=0.000）、年龄（?字2=1 011.396，P=0.000）及季节（?字2=1 070.282，P=0.000）病毒感染差异有统计学意义。（4）2009年毛细支气管炎、肺炎、支气管炎及喉气管支气管炎患儿中RSV、PIV3 及IVA为其病毒病原感染前3位。在上呼吸道感染中居前3位的病毒病原为ADV、IVA及PIV3。（5）在4 810例肺炎中，重症肺炎268例，病毒阳性率为 60.07%；重症肺炎组与普通肺炎组病毒阳性率比较，差异有统计学意义（?字2=51.160，P=0.000）。结论：（1）病毒仍是呼吸道感染性疾病的主要病原，7种呼吸道常见病毒中RSV仍居于首位，PIV3次之，再次为ADV。（2）RSV感染秋冬季多见，ADV及PIV3以春夏季多见。（3）病毒感染与性别、年龄及季节有关。（4）在下呼吸道感染中，RSV、PIV3及IVA为主要病毒病原，在上呼吸道感染中ADV、IVA及PIV3是主要病毒病原。（5）重症肺炎病毒阳性率高于普通肺炎，重症肺炎组RSV阳性率明显高于普通肺炎组。

Abstract:

Objective：To discuss epidemiological characteristics and pathogenic condition of common respiratory tract viral infection in hospitalized children in Chongqing. Methods：Totally 19 452 patients hospitalized in respiratory ward from 2009 to 2011 were retro－spectively analyzed. Direct immunofluorescent method was used to detect seven common respiratory viruses in nasopharyngeal secre－tions including respiratory syncytial virus（RSV），adenovirus（ADV），influenza virus A（IVA），influenza virus B（IVB） and parainfluen－za virus（PIV）. Epidemiological data and diseases caused by viruses in 2009 were analyzed retrospectively. Results：（1）Positive rates of each virus were RSV 29.23%，ADV 3.98%，IVA 2.54%，IVB 0.47%，PIV1 1.94%，PIV2 0.25%，PIV3 9.83%. （2）Peak periods of RSV infection were December and January. Both PIV3 and ADV were common from April to July. （3）Statistics results of virus infection of different genders（ ?字2=75.014，P=0.000），ages（ ?字2=1 011.396，P=0.000） and seasons（ ?字2=1 070.282，P=0.000） became statistically sig－nificant. （4）In 2009，RSV，PIV3 and IVA were the top 3 viruses among pneumonia，bronchiolitis，bronchitis and laryngotracheobron－chitis children；ADV，IVA and PIV3 were the top 3 viruses in the upper respiratory infection children. （5）In 4 810 pneumonia cases，severe pneumonia were 268 cases and its virus positive rate was 60.07%. Statistics results of virus infection rate between common pneumonia and severe pneumonia were statistically significant（ ?字2=51.160，P=0.000）. Conclusions：（1）Virus was still the main pathogen of respiratory infection disease. RSV still took the first place of viral pathogens，followed by PIV3 and ADV. （2）RSV are com－mon in autumn and winter while ADV and PIV3 are common in spring and summer. （3）Virus infections are relevant with gender，age and season. （4）RSV，PIV3 and IVA are the main viral pathogens in the lower respiratory infection. ADV，IVA and PIV3 are the main viral pathogens in the upper respiratory infection. （5）Virus positive rate and RSV positive rate of severe pneumonia are higher than those of common pneumonia.