银川市下呼吸道感染住院患儿中人鼻病毒的流行病学及临床特征分析

Epidemiological and clinical characteristics of human rhinovirus infection in children hospitalized due to lower respiratory tract infections in Yinchuan，China

摘要:

目的 回顾性分析银川市下呼吸道感染患儿中人鼻病毒的流行病学及临床特征，为儿童预防人鼻病毒（human rhinovirus，HRV）及临床诊疗提供理论依据。方法 采集2018至2019年因下呼吸道感染就诊于银川市妇幼保健院儿科的989例住院患儿的下呼吸道分泌物，采用多重PCR方法检测标本中病毒检出情况，分析人鼻病毒病例的基本情况、临床特征及实验室检查指标。结果 本研究989例下呼吸道感染患儿中，HRV总检出率为38.3%，HRV单纯感染率为9.5%，混合其他病毒感染率为28.9%；感染HRV的男患儿有221例（58.3%），女患儿有158例（41.7%）；HRV感染常年都有发生，但主要流行在夏季和秋季；HRV感染患儿87.3%被诊断为肺炎，13.7%为支气管和毛细支气管炎；90.2%的感染患儿为小于6岁的儿童。HRV感染和非HRV感染患儿相比，HRV感染组发热和呕吐症状明显（P<0.05），而咳嗽、喘息、喘憋、闻及喘鸣音等临床特征方面没有统计学差异（P>0.05），在实验室检查指标分析中，血红蛋白、红细胞计数、谷草转氨酶、谷丙转氨酶以及乳酸酶含量均存在明显差异（P<0.05）；结论 HRV是银川地区常见的下呼吸道感染病原体，6岁以下儿童极易感染，以发热为主要症状，且HRV感染会引发肺炎、支气管炎及毛细支气管炎下呼吸道感染疾病；HRV常与其他病毒混合感染；具有以夏、秋季为感染高峰的明显的季节性流行。

Abstract:

Objective To retrospectively analyze the epidemiological and clinical characteristics of human rhinovirus（HRV） infection in children with lower respiratory tract infections in Yinchuan，China，and to provide a theoretical basis for prevention，diagnosis，and treatment of HRV in children.Methods The lower respiratory secretion specimens from 989 children with lower respiratory tract infections hospitalized in the Department of Pediatrics of Yinchuan Women and Children Healthcare Hospital from 2018 to 2019 were collected for virus detection by multiplex PCR. The basic information，clinical characteristics，and laboratory results of HRV cases were analyzed.Results Among the 989 children with lower respiratory tract infections，the total detection rate of HRV was 38.3%，the rate of HRV infection alone was 9.5%，and the rate of mixed infection with HRV and other viruses was 28.9%. There were 221（58.3%） male children and 158（41.7%） female children infected with HRV. HRV infections occurred all year round，but were mainly prevalent in summer and autumn. Of the children with HRV infection，87.3% were diagnosed with pneumonia and 13.7% with bronchitis and bronchiolitis，and 90.2% were less than six years old. Compared with non-HRV-infected children，HRV-infected children were more frequently to have fever and vomiting（P<0.05），but with no significant differences in clinical features such as cough，wheezing，stridor，and wheezing sounds（P>0.05）. In terms of laboratory indicators，there were significant differences in the levels of hemoglobin，red blood cell count，aspartate aminotransferase，alanine aminotransferase，and lactase（P<0.05）.Conclusion HRV is a common pathogen of lower respiratory tract infections in Yinchuan. Children under six years old are highly susceptible to HRV，with fever as the main symptom，and HRV infection can affect the lower respiratory tract to cause pneumonia，bronchitis，and bronchiolitis. HRV infection often co-exists with other viruses，with seasonal epidemics mainly during summer and autumn.