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目的探讨苏州地区因急性呼吸道感染住院患儿中人类博卡病毒(human bocavirus,HBoV)感染的临床特征。方法收集2009年1月—2010年12月因急性呼吸道感染住院的3 826例患儿的痰标本,应用实时PCR检测HBoV DNA,直接免疫荧光法检测呼吸道合胞病毒、流感病毒(A、B)、副流感病毒(1～3)和腺病毒,同时采用逆转录PCR检测人偏肺病毒RNA,并进行细菌培养及荧光定量PCR检测支原体DNA,分析HBoV感染的临床特点及流行病学特征,并与呼吸道合胞病毒(RSV)进行比较。结果 3 816份标本共检测到HBoV 272例(7.13%),仅次于RSV;HBoV单独感染率为32.7%,与其他呼吸道病毒的合并感染率为18.38%,高于RSV和其他病毒的合并感染率(P<0.05)。HBoV感染全年均有发生,夏季最多;6～18月龄婴幼儿检出率最高,占48.17%。在住院患儿中,HBoV主要引起支气管肺炎(85.39%),临床症状主要表现为咳嗽(96.63%)、喘息(46.07%)、发热(56.18%)。与RSV相比,HBoV感染患儿的白细胞、中性粒细胞比例、CRP均高于RSV,差异有统计学意义(P<0.05)。结论 HBoV是苏州地区小儿呼吸道感染的重要病原体之一,有单独的致病性,与RSV相比,在年龄、季节分布、临床症状、实验室指标等方面有明显差异。
Objective To investigate the clinical characteristics of human bocavirus (HBoV) infection in hospitalized children with acute respiratory infection in Suzhou area. Methods The sputum samples of 3 826 children hospitalized with acute respiratory infection from January 2009 to December 2010 were collected. The HBoV DNA was detected by real-time PCR, and the respiratory syncytial virus, influenza virus (A, B) , Parainfluenza virus (1 ~ 3) and adenovirus. Meanwhile, reverse transcriptase PCR was used to detect human metapneumovirus RNA. Mycoplasma DNA was detected by bacterial culture and fluorescent quantitative PCR. The clinical features and epidemiological characteristics of HBoV infection were analyzed. Compared with respiratory syncytial virus (RSV). Results A total of 272 samples (7.13%) were detected in 3 816 samples, second only to RSV. The individual infection rate of HBoV was 32.7%, and the combined infection rate with other respiratory viruses was 18.38%, higher than those of RSV and other viruses Rate (P <0.05). HBoV infection occurred throughout the year, the most in summer; 6 to 18 months of age, the highest detection rate of infants, accounting for 48.17%. In hospitalized children, HBoV mainly caused bronchopneumonia (85.39%). The main clinical symptoms were cough (96.63%), wheezing (46.07%) and fever (56.18%). Compared with RSV, HBeV infection in children with leukocyte, neutrophil ratio, CRP were higher than RSV, the difference was statistically significant (P <0.05). Conclusion HBoV is one of the most important pathogens of respiratory tract infection in children in Suzhou. It has a single pathogenicity. Compared with RSV, HBoV has obvious differences in age, seasonal distribution, clinical symptoms and laboratory indexes.