2009-2011年重庆地区儿童呼吸道病毒感染流行特征分析

发布时间：2018-06-24 05:41

本文选题：儿童 + 呼吸道感染　；参考：《重庆医科大学》2012年硕士论文

【摘要】：目的分析比较重庆地区儿童常见呼吸道病毒感染的流行特征及致病情况。方法回顾性分析2009年1月～2011年12月入住呼吸科病房的住院患儿流行病学资料，共19452例。入院当日抽取鼻咽部分泌物，采用直接免疫荧光法检测7种常见呼吸道病毒，包括呼吸道合胞病毒(RSV)、腺病毒（ADV）、流感病毒A(IVA)、流感病毒B（IVB）及副流感病毒1、2、3（PIV1、2、3）。结果 1、病毒阳性者为9387例，总阳性率为48.26%；7种常见呼吸道病毒的检出阳性率分别为RSV29.23%、ADV3.98%、IVA2.54%、IVB0.48%、PIV11.95%、PIV20.25%，PIV39.83%。 2、混合感染者604例，混合感染率为3.11%。RSV合并其他病毒混合感染为516例，占混合感染的85.43%（516/604），其中RSV+PIV3为238例，占总混合感染的39.40%（238/604）。混合感染率在11月、12月、1月及2月份常见。 3、RSV感染高峰在每年12月及1月，其次为11月及2月，而在5月、6月及7月份其感染率最低。PIV3感染在4、5、6及7月份多见。ADV在每年4—7月份有感染高峰，其中5、6月份为最高值，而11月份及12月份则少见。流感病毒中，IVA总阳性率为2.54%（495/19452），IVB总阳性率为0.47%（92/19452）。PIV1在2009年中9月—12月多见，2010年及2011年在2月—5月份多见。PIV2在2009年9月、2010年4月及2011年3、8月相对多见。 4、不同性别、年龄及季节病毒感染差异有统计学意义。5、2009年6341例患儿中，病毒总感染例数2652例，阳性率为41.82%。毛细支气管炎患儿病毒阳性率71.41%，其病毒构成比中RSV为82.72%。毛细支气管炎、肺炎、支气管炎及喉气管支气管炎患儿中RSV、PIV3及IVA为其病毒病原感染前3位。在上呼吸道感染中居前3位的病毒病原为腺病毒（ADV）、流感病毒A（IVA）及副流感病毒3型（PIV3）。结论 1、病毒仍是呼吸道感染性疾病的主要病原，7种呼吸道常见病毒中RSV仍居于呼吸道感染病毒病原的首位，，PIV3次之，再次为ADV。从高到低顺序为RSV＞PIV3＞ADV＞IVA＞PIV1＞IVB＞PIV2。 2、混合感染在冬季多见；RSV合并其他病毒感染占混合感染的绝大多数，尤其是RSV+PIV。 3、RSV、ADV及PIV3具有明显的流行特征；RSV感染秋冬季多见，ADV及PIV3以春夏季多见，其余4种病毒感染无明显流行特征。 4、病毒感染与性别、年龄及季节有关。 5、在下呼吸道感染中，RSV、PIV3及IVA为主要病毒病原，在上呼吸道感染中ADV、IVA及PIV3是主要病毒病原。
[Abstract]:Objective to analyze and compare the epidemic characteristics and pathogenicity of common respiratory tract virus infection in children in Chongqing. Methods Epidemiological data of 19452 hospitalized children admitted to respiratory ward from January 2009 to December 2011 were retrospectively analyzed. Nasopharyngeal secretions were collected on admission day, and seven common respiratory viruses, including respiratory syncytial virus (RSV), adenovirus (ADV), influenza virus A (IVA), influenza virus B (IVB) and parainfluenza virus (PIV1), were detected by direct immunofluorescence assay. Results 1. 9387 cases were positive for virus, and the total positive rate was 48.26%. The positive rates of the seven common respiratory viruses were RSV29.233.98 and ADV3.98A2.54IVB 0.48 and PIV11.95. 95% PIV39.833.2, 604 cases of mixed infection, and 516 cases of mixed infection with RSV and other viruses. It accounted for 85.43% (516 / 604) of mixed infections, of which 238 cases were RSV PIV3, accounting for 39.40% (238 / 604) of total mixed infections. Mixed infection rates were common in November, December, January and February. The peak of RSV infection was in December and January, followed by November and February. However, in May, June and July, the infection rate of .PIV3 was the lowest in April and July. The peak of .ADV was observed in April and July, with the highest infection in May and June, but rare in November and December. The total positive rate of IVA in influenza viruses was 2.54% (495 / 19452). The total positive rate of IVB was 0.47% (92 / 19452) .PIV1 was more common in mid-September and December 2009, and in February-May in 2010 and 2011, in September 2009, April and March 2010 and August 2011. There were significant differences in age and seasonal virus infection. Among the 6341 cases in 2009, 2652 cases were infected with virus, and the positive rate was 41.82%. The positive rate of virus in bronchiolitis was 71.41 and RSV was 82.72. In children with bronchiolitis, pneumonia, bronchitis and laryngotracheal bronchitis, RSVP IV3 and IVA were the top three viral pathogens. Adenovirus (ADV), influenza virus A (IVA) and parainfluenza virus type 3 (PIV3) were the top three pathogens of upper respiratory tract infection. Conclusion 1. RSV is still the main pathogen of respiratory tract infection. RSV is still the first pathogen of respiratory tract infection virus, followed by ADV. The order from high to low was RSV > PIV3 > ADV > IVA > PIV1 > IVB > PIV2.2. In winter, RSV combined with other viruses accounted for the majority of mixed infections, especially RSV PIV.3 RSVN ADV and PIV3 had obvious epidemic characteristics. RSV infection was more common in autumn and winter, ADV and PIV3 were more common in spring and summer, the other four kinds of virus infection had no obvious epidemic characteristics. 4, virus infection and sex. Age and season were related. 5. RSVV PIV3 and IVA were the main viral pathogens in lower respiratory tract infection, and ADV IVA and PIV3 were main viral pathogens in upper respiratory tract infection.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.6

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