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目的了解急性下呼吸道感染(ALRI)住院患儿病毒感染情况及其临床特征。方法收集2004-2006年冬季(11月至次年2月)因ALRI在北京儿童医院住院治疗的<5岁患儿鼻咽吸出物333份。男230例,女103例;年龄1个月～4.8岁。采用PCR技术和病毒分离方法对鼻咽吸出物进行呼吸道合胞病毒(RSV)、腺病毒(AdV)、副流感病毒(PIV)1～4型、鼻病毒(RhV)、人偏肺病毒(hMPV)、冠状病毒(HCoV)及人博卡病毒(HBoV)检测。采用人喉上皮癌细胞和非洲猴肾细胞对鼻咽吸出物进行病毒分离,对阳性结果进行序列测定和鉴定。结果ALRI333例患儿中,病毒检测阳性123份(36.94%),其中RSV阳性102例,AdV、HBoV阳性各16例,RhV阳性1例,其中12例为双重阳性。未检测到PIV、hMPV及HCoV。333份鼻咽吸出物中病毒分离得到11株病毒株,经PCR扩增及序列测定证实均为AdV,包括AdV1型2株,AdV2型、AdV3型、AdV7型各3株。肺炎患儿病毒阳性检出率为30.35%,毛细支气管炎患儿病毒阳性检出率为62.50%,急性支气管炎患儿病毒阳性检出率为23.08%,毛细支气管炎患儿病毒阳性检出率高于肺炎和急性支气管炎患儿(χ2=24.75,19.66Pa<0.01)。结论RSV感染在北京儿童医院2004-2006年冬季ALRI住院患儿中占首位;感染的AdV血清型包括AdV1型、AdV2型、AdV3型及AdV7型;HBoV可能是ALRI的重要病原。毛细支气管炎患儿病毒感染检出率最高。
Objective To understand the prevalence of viral infection and its clinical characteristics in hospitalized children with acute lower respiratory tract infection (ALRI). Methods A total of 333 nasopharyngeal aspirates from children aged <5 years admitted to Beijing Children’s Hospital during the winter of 2004-2006 (November to February) were collected. 230 males and 103 females; aged 1 month to 4.8 years old. The respiratory syncytial virus (RSV), adenovirus (AdV), parainfluenza virus (PIV) 1-4, rhinovirus (RhV), human metapneumovirus (hMPV ), Coronavirus (HCoV) and human Boka virus (HBoV). Human laryngeal carcinoma cells and African monkey kidney cells were used for virus isolation of nasopharyngeal aspirates, and the positive results were sequenced and identified. Results Among the 133 ALR patients, 123 (36.94%) were positive for the virus, of which 102 were RSV positive, 16 were positive for AdV and HBoV, and 1 was RhV positive, of which 12 were double positive. No PIV, hMPV and HCoV were detected. Of the 333 nasopharyngeal aspirates, 11 strains of viruses were isolated and identified as AdV1 by PCR amplification and sequencing, including 2 strains of AdV1, 3 strains of AdV2, 3 strains of AdV3 and 3 strains of AdV7. The positive rate of virus in children with pneumonia was 30.35%. The positive rate of virus in children with bronchiolitis was 62.50%. The positive rate of virus in children with acute bronchitis was 23.08%. The positive rate of virus in children with bronchiolitis Higher than pneumonia and acute bronchitis in children (χ2 = 24.75,19.66Pa <0.01). Conclusions RSV infection is the most common form of hospitalized children with ALRI in Beijing Children’s Hospital in the winter of 2004-2006. The infected serotypes of AdV1 include AdV1, AdV2, AdV3 and AdV7. HBoV may be an important pathogen of ALRI. Bronchiolitis in children with the highest detection rate of viral infection.