7360例呼吸道感染儿童病毒抗原七联检的临床结果分析
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摘要
目的通过对四川大学华西第二医院就诊的7 360例急性呼吸道感染患儿进行呼吸道病毒抗原检测,分析不同病毒在急性呼吸道感染中的分布情况,为儿童呼吸道感染的早期诊治提供流行病学依据。方法提取患儿鼻咽拭子,采用直接免疫荧光法(DFA)检测7种呼吸道病毒抗原,包括流感病毒A型(Flu A)、流感病毒B型(Flu B)、副流感病毒1型(PIV1)、副流感病毒2型(PIV2)、副流感病毒3型(PIV3)、呼吸道合胞病毒(RSV)和腺病毒(ADV)。结果 7 360例急性呼吸道感染患儿中,检出呼吸道病毒783例,检出率为10.64%。其中检出率最高的是RSV 545例(7.40%),其次分别为PIV3 107例(1.45%),ADV 62例(0.84%),Flu B 25例(0.34%),Flu A 24例(0.33%),PIV1 18例(0.24%),混合型8例(0.11%),PIV2 2例(0.03%)。结论 7项呼吸道病毒检测可以明确引起患儿急性呼吸道感染的病原体,为临床用药提供合理诊断依据,对临床药物合理使用具有指导意义。
Objective To analyze the distribution of different viruses in acute respiratory tract infections by detecting respiratory viral antigens in 7 360 children with acute respiratory tract infections in West China Second Hospital of Sichuan University,in order to provide epidemiological basis for early diagnosis and treatment of children's respiratory tract infections.Methods Nasopharyngeal swabs were extracted and 7 respiratory viruses were detected by direct immunofluorescence(DFA),including influenza A(Flu A),influenza B(Flu B),parainfluenza type 1(PIV1),parainfluenza virus type 2(PIV2),parainfluenza virus type 3(PIV3),respiratory syncytial virus(RSV)and adenovirus(ADV).Results Among 7 360 children in this study,783 cases of respiratory virus were detected,and the detection rate was 10.64%.The highest detection rate was 545 cases(7.40%)of RSV,followed by 3 107 cases of PIV(1.45%),62 cases of ADV(0.84%),25 cases of FluB(0.34%),24 cases of Flu A(0.33%),18 cases of PIV1(0.24%),8 cases of mixed type(0.11%)and 2 cases of PIV2(0.03%).Conclusion Seven-respiratory-virus test can identify the pathogens causing acute respiratory infection in children,provide a reasonable diagnostic basis for clinical use,and have guiding significance for the rational use of clinical drugs.
Objective To analyze the distribution of different viruses in acute respiratory tract infections by detecting respiratory viral antigens in 7 360 children with acute respiratory tract infections in West China Second Hospital of Sichuan University,in order to provide epidemiological basis for early diagnosis and treatment of children's respiratory tract infections.Methods Nasopharyngeal swabs were extracted and 7 respiratory viruses were detected by direct immunofluorescence(DFA),including influenza A(Flu A),influenza B(Flu B),parainfluenza type 1(PIV1),parainfluenza virus type 2(PIV2),parainfluenza virus type 3(PIV3),respiratory syncytial virus(RSV)and adenovirus(ADV).Results Among 7 360 children in this study,783 cases of respiratory virus were detected,and the detection rate was 10.64%.The highest detection rate was 545 cases(7.40%)of RSV,followed by 3 107 cases of PIV(1.45%),62 cases of ADV(0.84%),25 cases of FluB(0.34%),24 cases of Flu A(0.33%),18 cases of PIV1(0.24%),8 cases of mixed type(0.11%)and 2 cases of PIV2(0.03%).Conclusion Seven-respiratory-virus test can identify the pathogens causing acute respiratory infection in children,provide a reasonable diagnostic basis for clinical use,and have guiding significance for the rational use of clinical drugs.
引文
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[16]王梅.小儿急性呼吸道感染的病原学研究[J].中国儿童保健杂志,2003,11(2):117-118.
[17]钱雄杰,沈昊.急性呼吸道感染患儿呼吸道病毒检测结果临床分析[J].吉林医学,2013,34(19):3808-3809.
[18]FEARNS R,DEVAL J.New antiviral approaches for respiratory syncytial virus and other mononegaviruses:Inhibiting the RNA polymerase[J].Antiviral Res,2016,134(6):63-76.
[19]赖伟兰,陈亚军.2162例婴幼儿急性呼吸道感染病毒抗原的诊断意义[J].检验医学与临床,2017,4(14):1119-1121.
[20]张拓慧,赵林清.人呼吸道合胞病毒的流行病学研究进展[J].病毒学报,2017,33(6):938-943.
[2] FENDRICK A M,MONTO A S,NIGHTENGALE B,et al.The economic burden of non-influenza-related viral respiratory tract infection in the United States[J].Arch Intern Med,2003,163(4):487-494.
[3] MOESKER F M,VAN KAMPEN J J,ARON G,et al.Diagnostic performance of influenza viruses and RSV rapid antigen detection tests in children in tertiary care[J].J Clin Virol,2016,79(8):12-17.
[4] CHEN L,TIAN Y,CHEN S,et al.Performance of the Cobas?Influenza A/B assay for rapid pcr-based detection of influenza compared to prodesse ProFlu+and viral culture[J].Eur JMicrobiol Immunol,2015,5(4):236-245.
[5] SHOJAEI T R,TABATABAEI M,SHAWKY S,et al.A review on emerging diagnostic assay for viral detection:the case of avian influenza virus[J].MolBiol Rep,2015,42(1):187-199.
[6] HUANG Y,HUA J,WANG D,et al.Risk factors of respiratory syncytial virus infection among pediatric influenzaike illness and severe acute respiratory infections in Suzhou,China[J].J Med Virol,2017,90(3):397-404.
[7] KARPPINEN S,TOIVONEN L,SCHUEZ H L,et al.Interference between respiratory syncytial virus and rhinovirus in respiratory tract infections in children[J].Clin Microbiol Infect,2016,22(2):208.e1-208.e6.
[8] KOLAWOLE O,OGUNTOYE M,DAM T,et al.Etiology of respiratory tract infections in the community and clinic in Ilorin,Nigeria[J].BMC Res Notes,2017,10(1):712.
[9] GIAMBERARDIN H I,HOMSANI S,BRICKS L F,et al.Clinical and epidemiological features of respiratory virus infections in preschool children over two consecutive influenza seasons in southern Brazil[J].J Med Virol,2016,88(8):1325-1333.
[10]韩晓华,刘立云,敬宏,等.小儿肺炎支原体肺炎合并全身炎性反应综合征时炎性相关因素的变化及临床意义[J].中国当代儿科杂志,2007,9(4):347.
[11]罗均彪,儿童呼吸道病毒感染1288例七联病毒检测结果临床分析[J].现代医药卫生,2015,31(21):3238-3240.
[12] WANG H,ZHENG Y,DENG J,et al.Prevalence of respiratory viruses among children hospitalized from respiratory infections in Shenzhen,China[J].Virol J,2016,13(1):39.
[13]王倩,杜永刚.儿童呼吸道病毒感染发病特点及影响因素[J].基层医学论坛,2015,16(15):2083-2084.
[14]TAYLORS,LOPEZ P,WECKX L,et al.Respiratory viruses and influenza-like illness:epidemiology and outcomes in children aged 6months to 10years in a multicountry population sample[J].J Infect,2017,74(1):29-41.
[15]武悦,张洪珠.对儿童肺炎支原体特异性抗体的实验室检测及方法学分析[J].中国优生与遗传杂志,2008,16(2):116.
[16]王梅.小儿急性呼吸道感染的病原学研究[J].中国儿童保健杂志,2003,11(2):117-118.
[17]钱雄杰,沈昊.急性呼吸道感染患儿呼吸道病毒检测结果临床分析[J].吉林医学,2013,34(19):3808-3809.
[18]FEARNS R,DEVAL J.New antiviral approaches for respiratory syncytial virus and other mononegaviruses:Inhibiting the RNA polymerase[J].Antiviral Res,2016,134(6):63-76.
[19]赖伟兰,陈亚军.2162例婴幼儿急性呼吸道感染病毒抗原的诊断意义[J].检验医学与临床,2017,4(14):1119-1121.
[20]张拓慧,赵林清.人呼吸道合胞病毒的流行病学研究进展[J].病毒学报,2017,33(6):938-943.