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目的了解长沙地区急性下呼吸道感染(ALRTI)住院儿童中常见呼吸道病毒的流行特点,为本地区儿童ALRTI的防治提供依据。方法收集2007年9月至2008年8月诊断为ALRTI的住院患儿鼻咽抽吸物标本1165份,采用RT-PCR方法检测呼吸道合胞病毒(RSV)、鼻病毒(HRV)、流感病毒A(IFVA)、流感病毒B(IFVB)、副流感病毒1～3(PIV1～3)、偏肺病毒(hMPV)、冠状病毒NL63(HCoV-NL63)及冠状病毒HKU1(HCoV-HKU1);PCR方法检测腺病毒(ADV)、博卡病毒(HBoV);巢式PCR方法检测多瘤病毒WU(WUPyV)和多瘤病毒KI(KIPyV)。并对阳性标本进行基因测序以证实。结果 1165份标本中有871份检出了病毒,总检出率74.76%,其中RSV最为常见,检出率为27.03%,其次为HRV(17.33%)、PIV3(13.73%)及新发现病毒HBoV(8.67%)和hMPV(6.52%)。病毒总检出率在男女之间差异无统计学意义,但男性PIV3、hMPV和HBoV的阳性检出率高于女性。病毒阳性检出率在各年龄组之间差异有统计学意义(χ2=10.934,P=0.027),以6个月至1岁以内年龄组检出率最高。病毒总检出率在四季分布差异有统计学意义(χ2=12.307,P=0.006),以冬季检出率最高。结论病毒病原在长沙地区儿童ALRTI中占重要地位,其中RSV、HRV及PIV3是主要病毒病原,近年新发现的HBoV和hMPV也占较高比例;病毒检出率以6个月至1岁以内年龄组最高;冬季病毒总检出率高于其他季节。
Objective To understand the prevalence of common respiratory viruses in hospitalized children with acute lower respiratory tract infection (ALRTI) in Changsha and to provide basis for the prevention and treatment of ALRTI in children in this area. Methods A total of 1165 nasopharyngeal aspirates samples from hospitalized children with ALRTI diagnosed from September 2007 to August 2008 were collected. The respiratory syncytial virus (RSV), rhinovirus (HRV), influenza virus A (IFVB), parainfluenza virus 1-3 (PIV 1-3), metapneumovirus (hMPV), coronavirus NL63 (HCoV-NL63) and coronavirus HKU1 (HCoV-HKU1) Detection of adenovirus (ADV), Bocavirus (HBoV); nested PCR detection of polyoma virus WU (WUPyV) and polyomavirus KI (KIPyV). Positive samples were confirmed by gene sequencing. Results 871 out of 1165 samples were detected with a total detection rate of 74.76%. RSV was the most common, with a detection rate of 27.03%, followed by HRV (17.33%), PIV3 (13.73%) and newly discovered virus HBoV (8.67%) and hMPV (6.52%). The overall detection rate of the virus was not statistically different between men and women, but the positive rate of PIV3, hMPV and HBoV in males was higher than that in females. The positive rate of virus positive was statistically significant among all age groups (χ2 = 10.934, P = 0.027), with the highest detection rate in the age group from 6 months to 1 year old. The total detection rate of the virus in the four seasons was significantly different (χ2 = 12.307, P = 0.006), with the highest detection rate in winter. Conclusions The viral pathogens play an important role in the ALRTI of children in Changsha. Among them, RSV, HRV and PIV3 are the major viral pathogens. HBoV and hMPV are also found in recent years in a high proportion. The detection rate of viruses is 6 months to less than 1 year The highest in the group; the total detection rate of winter virus is higher than other seasons.