急性下呼吸道感染住院儿童病毒谱调查及人副流感病毒1-4型的现状分析
发布时间：2018-08-31 19:42
【摘要】：第一部分2010-2011年长沙地区急性下呼吸道感染住院儿童病毒谱调查 目的： 了解2010～2011年长沙地区急性下呼吸道感染(acute low respiratory tract infection, ALRTI)住院儿童常见呼吸道病毒的流行病学特点,为本地区儿童ALRTI的防治提供参考资料。方法： 1、收集2010年3月～2011年2月在湖南省人民医院暨湖南师范大学第一附属医院儿科医学中心因ALRTI住院的儿童鼻咽抽吸物(Nasopharyngeaaspirates samples, NPAs)标本。 2、采用PCR方法检测ADV, RT-PCR方法检测HPIV3、RSV、 HRV、IFVA、B、HMPV、HCoV-NL63、HCoV-HKUl、Nest-PCR方法检测HPIV1、HPIV2、HPIV4、HBoV,并对阳性扩增产物进行基因测序,所得结果与美国国立生物技术中心(NCBI) GeneBank中的序列进行BLAST比对证实。 3、对各种病毒在儿童ALRTI中的流行病学特点进行分析。结果： 1、2010年3月～2011年2月共收集771例患儿的NPAs标本,711份NPAs标本中有536份检出病毒,总检出率为69.52%(536/771),位居前三位的是HRV、RSV、HPIV3;之后依次为HBoV、ADV、 HMPV、HPIV4、IFVB、IFVA、HPIV1、HCoV-HKU1、HCoV-NL63、 HPIV2和HBoV2。 2、检出病毒的536例患儿中,男性检出354例(72.09%),女性检出182例(65.00%),男女阳性检出率之比为1.94：1,男性居多,男女之间比较差异有统计学意义(x2=4.239,P=0.039)。14种病毒男女之间阳性检出率比较无统计学差异。 3、纳入研究的患儿年龄在0-14岁之间,平均23.65个月。病毒阳性检出在5岁以下患儿中占95.70%,3岁以下占80.59%。病毒检出率在各年龄段之间比较有统计学差异(x2=40.968,P=0.000)；其中RSV、IFVA、IFVB、HPIV3和ADV阳性检出率在年龄段分布上比较有统计学差异,其余病毒无差异。 4、在研究期间内,病毒检出率在季节分布上有统计学差异(x2=22.211,P=0.000),以春季检出率最高；不同病毒阳性检出率的季节分布有不同,RSV在冬季检出率最高,其次为春季；HRV和ADV均在秋季有一个检出率高峰；HBoV1和HPIV3在春夏季检出为主,尤其是夏季更多；HPIV4夏季为多；IFVB和HMPV的检出高峰均为春季；IFVA和HCoV-HKU1仅在夏秋季有检出。 结论： 1、本研究期间内ALRTI住院儿童病毒检出率为69.52%,表明病毒在长沙地区儿童ALRTI中仍占有重要地位。 2、本研究期电ALRTI住院儿童病毒谱构成前三位的是HRV、RSV、PIV3,ADV检出率较往年明显增高。 3、本资料中3岁以下患儿病毒检出占80.59%；在各年龄段之间病毒检出率有统计学差异,不同病毒有各自的年龄分布特点；病毒检出男性居多；春季检出率最高,不同病毒也有各自季节分布特点。 第二部分人副流感病毒1-4型在长沙地区急性下呼吸道感染住院儿童中的现状分析 目的： 了解HPIV1、2、3、4型在长沙地区ALRTI住院儿童中的流行病学特点,探讨HPIV4在本地区ALRTI儿童中的流行状况、临床特点以及与其他HPIV之间的差异,为进一步研究奠定基础。 方法： 1、收集2010年3月～2011年2月在湖南省人民医院暨湖南师范大学第一附属医院儿科医学中心因ALRTI住院儿童NPAs标本。 2、采用Nest-PCR方法检测HPIV1-4型,并对扩增产物进行测序,所得测序结果与美国国立生物技术中心(NCBI) GeneBank中的序列进行BLAST比对分析,并采用MEGA4软件对序列进行分析并绘制进化树。 3、对HPIV4与其它型别HPIV在儿童ALRTI中的流行病学和临床特点进行比较和分析。 结果： 1、本研究771例NPAs标本中共检出HPIV148例,检出率为19.19%(148/771); HPIV1、HPIV2、HPIV3、HPIV4型分别检出12例、4例、107例和28例,检出率分别为1.55%、0.51%、13.87%和3.63%。 2、HPIV阳性检出患儿中男性98例,女性50例,男女检出率之比为1.96：1。HPIV1-4型检出率性别间比较均无统计学差异。HPIV阳性检出患儿年龄均在5岁之内,主要集中在1岁以下；其中,HPIV1在6个月以下年龄段无检出,1-3岁之间检出率稍高；]HPIV2仅在6-36个月之间检出4例；HPIV3以3岁以内患儿为主,特别是1岁以内的儿童占65.42%；HPIV4在5岁以下的各年龄段散在分布。仅HPIV3的检出率在各年龄段之间比较有统计学差异(X2=29.648,P=0.000)。HPIV3和HPIV4均在夏季检出率最高。单一检出HPIV阳性88例,与其它病毒的混合检出60例(40.54%),其中最多见为HBoV。HPIV1、2、3、4与其他病毒混合检出分别为3例、3例、46例和11例。 3、HPIV4的检出率在HPIV1-4型中居第二位,有两个亚基因型共同流行,以HPIV4a为主；夏季为流行高峰；在5岁以下的各年龄段均有检出；无性别间差异；临床表现与HPIV3类似。 结论： 1、HPIV4是长沙地区ALRTI住院儿童的重要病毒病原。 2、本研究期间内]HPIV4有两个亚基因型流行,以HPIV4a为主,阳性检出患儿均在5岁以下,无性别间差异,夏季为流行高峰,临床特点与HPIV3类似。 3、本研究期间HPIV1、2、3的流行状况有各自特点。
[Abstract]:Part I survey of the viral spectrum of hospitalized children with acute lower respiratory tract infection in Changsha during the past 2010-2011 years
Objective:
Objective To investigate the epidemiological characteristics of common respiratory viruses in hospitalized children with acute lower respiratory tract infection (ALRTI) in Changsha from 2010 to 2011, and to provide references for the prevention and treatment of ALRTI in children in Changsha.
1. Nasopharyngeal aspirates (NPAs) from children hospitalized with ALRTI in the Pediatric Medical Center of Hunan Provincial People's Hospital and the First Affiliated Hospital of Hunan Normal University from March 2010 to February 2011 were collected.
2. PCR was used to detect ADV, RT-PCR was used to detect HPIV3, RSV, HRV, IFVA, B, HMPV, HCoV-NL63, HCoV-HKUl, Nest-PCR was used to detect HPIV1, HPIV2, HPIV4, HBoV, and the positive amplified products were sequenced. The results were confirmed by BLAST.
3, the epidemiological characteristics of various viruses in children ALRTI were analyzed.
From March 2010 to February 2011, a total of 771 NPAs specimens were collected from 771 children, and 536 of 711 NPAs were detected, with a total detection rate of 69.52% (536/771), HRV, RSV and HPIV3 in the top three, followed by HBoV, ADV, HMPV, HPIV4, IFVB, IFVA, HPIV1, HCoV-HKU1, HCoV-NL63, HPIV2 and HBoV 2.
2. Among 536 children with viruses, 354 (72.09%) were detected in males and 182 (65.00%) were detected in females. The ratio of male to female was 1.94:1, and the difference between males and females was statistically significant (x2 = 4.239, P = 0.039).
3. The children in the study were between 0 and 14 years old, with an average age of 23.65 months. The positive rate of virus was 95.70% in children under 5 years old and 80.59% in children under 3 years old. There was no difference in other viruses between the two groups.
4. During the study period, the virus detection rate showed statistical difference in seasonal distribution (x2 = 22.211, P = 0.000), with the highest detection rate in spring; the seasonal distribution of different virus positive detection rates was different, RSV detection rate in winter was the highest, followed by spring; both HRV and ADV detection rates had a peak in autumn; HBoV1 and HPIV3 detection rates in spring and summer were the highest. The detection of IFVB and HMPV peaked in spring, while IFVA and HCoV-HKU1 were detected only in summer and autumn.
Conclusion:
1. The detection rate of ALRTI in hospitalized children was 69.52%, indicating that the virus still played an important role in ALRTI in Changsha.
2. The detection rates of HRV, RSV, PIV3 and ADV in the first three viral profiles of ALRTI hospitalized children in this study period were significantly higher than those in previous years.
3. Viruses were detected in 80.59% of the children under 3 years old, and there were statistical differences in virus detection rates among different age groups, and different viruses had their own age distribution characteristics; most of the viruses were detected in males; the detection rate in spring was the highest, and different viruses also had their own seasonal distribution characteristics.
Part II Analysis of the status of human parainfluenza virus type 1-4 in hospitalized children with acute lower respiratory tract infection in Changsha
Objective:
Objective To understand the epidemiological characteristics of HPIV1,2,3,4 in hospitalized children with ALRTI in Changsha area, and to explore the epidemiological status, clinical characteristics and differences between HPIV4 and other HPIVs in children with ALRTI in Changsha area, so as to lay a foundation for further study.
Method:
1. NPAs specimens of children hospitalized with ALRTI in the Pediatric Medical Center of Hunan Provincial People's Hospital and the First Affiliated Hospital of Hunan Normal University from March 2010 to February 2011 were collected.
2. HPIV1-4 was detected by Nest-PCR, and the amplified products were sequenced. The sequencing results were compared with those from the National Center for Biotechnology (NCBI) GeneBank. The sequence was analyzed by MEGA4 software and the evolutionary tree was drawn.
3, the epidemiological and clinical characteristics of HPIV4 and other types of HPIV in children ALRTI were compared and analyzed.
Result:
1. In this study, 148 cases of HPIV were detected in 771 NPAs, the detection rate was 19.19% (148/771); 12 cases, 4 cases, 107 cases and 28 cases were detected in HPIV1, HPIV2, HPIV3 and HPIV4, respectively. The detection rates were 1.55%, 0.51%, 13.87% and 3.63%.
2. There were 98 males and 50 females in the HPIV positive children, the ratio of male to female was 1.96:1. There was no significant difference in the HPIV1-4 detection rate between the sexes. HPIV3 and HPIV4 were found in 4 cases between 6 and 36 months old, most of them were children under 3 years old, especially children under 1 year old, 65.42%; HPIV4 was scattered in all age groups under 5 years old. Sixty cases (40.54%) were found to be mixed with other viruses, the most common of which were HBoV. HPIV1, 2, 3, 4 mixed with other viruses in 3 cases, 3 cases, 46 cases and 11 cases respectively.
3. The detection rate of HPIV 4 was the second in HPIV1-4, with two subtypes co-epidemic, mainly HPIV4a, the peak of epidemic in summer, all age groups under 5 years old, no gender difference, and similar clinical manifestations with HPIV3.
Conclusion:
1, HPIV4 is an important viral pathogen of ALRTI hospitalized children in Changsha.
2. There were two subtypes of HPIV4 epidemic in this study period. The main subtype was HPIV4a. The positive children were all under 5 years old, and there was no gender difference. The epidemic peak was in summer. The clinical characteristics of HPIV4 were similar to that of HPIV3.
3, the prevalence of HPIV1,2,3 in this study has its own characteristics.
【学位授予单位】：湖南师范大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.1
本文编号：2215975
[Abstract]:Part I survey of the viral spectrum of hospitalized children with acute lower respiratory tract infection in Changsha during the past 2010-2011 years
Objective:
Objective To investigate the epidemiological characteristics of common respiratory viruses in hospitalized children with acute lower respiratory tract infection (ALRTI) in Changsha from 2010 to 2011, and to provide references for the prevention and treatment of ALRTI in children in Changsha.
1. Nasopharyngeal aspirates (NPAs) from children hospitalized with ALRTI in the Pediatric Medical Center of Hunan Provincial People's Hospital and the First Affiliated Hospital of Hunan Normal University from March 2010 to February 2011 were collected.
2. PCR was used to detect ADV, RT-PCR was used to detect HPIV3, RSV, HRV, IFVA, B, HMPV, HCoV-NL63, HCoV-HKUl, Nest-PCR was used to detect HPIV1, HPIV2, HPIV4, HBoV, and the positive amplified products were sequenced. The results were confirmed by BLAST.
3, the epidemiological characteristics of various viruses in children ALRTI were analyzed.
From March 2010 to February 2011, a total of 771 NPAs specimens were collected from 771 children, and 536 of 711 NPAs were detected, with a total detection rate of 69.52% (536/771), HRV, RSV and HPIV3 in the top three, followed by HBoV, ADV, HMPV, HPIV4, IFVB, IFVA, HPIV1, HCoV-HKU1, HCoV-NL63, HPIV2 and HBoV 2.
2. Among 536 children with viruses, 354 (72.09%) were detected in males and 182 (65.00%) were detected in females. The ratio of male to female was 1.94:1, and the difference between males and females was statistically significant (x2 = 4.239, P = 0.039).
3. The children in the study were between 0 and 14 years old, with an average age of 23.65 months. The positive rate of virus was 95.70% in children under 5 years old and 80.59% in children under 3 years old. There was no difference in other viruses between the two groups.
4. During the study period, the virus detection rate showed statistical difference in seasonal distribution (x2 = 22.211, P = 0.000), with the highest detection rate in spring; the seasonal distribution of different virus positive detection rates was different, RSV detection rate in winter was the highest, followed by spring; both HRV and ADV detection rates had a peak in autumn; HBoV1 and HPIV3 detection rates in spring and summer were the highest. The detection of IFVB and HMPV peaked in spring, while IFVA and HCoV-HKU1 were detected only in summer and autumn.
Conclusion:
1. The detection rate of ALRTI in hospitalized children was 69.52%, indicating that the virus still played an important role in ALRTI in Changsha.
2. The detection rates of HRV, RSV, PIV3 and ADV in the first three viral profiles of ALRTI hospitalized children in this study period were significantly higher than those in previous years.
3. Viruses were detected in 80.59% of the children under 3 years old, and there were statistical differences in virus detection rates among different age groups, and different viruses had their own age distribution characteristics; most of the viruses were detected in males; the detection rate in spring was the highest, and different viruses also had their own seasonal distribution characteristics.
Part II Analysis of the status of human parainfluenza virus type 1-4 in hospitalized children with acute lower respiratory tract infection in Changsha
Objective:
Objective To understand the epidemiological characteristics of HPIV1,2,3,4 in hospitalized children with ALRTI in Changsha area, and to explore the epidemiological status, clinical characteristics and differences between HPIV4 and other HPIVs in children with ALRTI in Changsha area, so as to lay a foundation for further study.
Method:
1. NPAs specimens of children hospitalized with ALRTI in the Pediatric Medical Center of Hunan Provincial People's Hospital and the First Affiliated Hospital of Hunan Normal University from March 2010 to February 2011 were collected.
2. HPIV1-4 was detected by Nest-PCR, and the amplified products were sequenced. The sequencing results were compared with those from the National Center for Biotechnology (NCBI) GeneBank. The sequence was analyzed by MEGA4 software and the evolutionary tree was drawn.
3, the epidemiological and clinical characteristics of HPIV4 and other types of HPIV in children ALRTI were compared and analyzed.
Result:
1. In this study, 148 cases of HPIV were detected in 771 NPAs, the detection rate was 19.19% (148/771); 12 cases, 4 cases, 107 cases and 28 cases were detected in HPIV1, HPIV2, HPIV3 and HPIV4, respectively. The detection rates were 1.55%, 0.51%, 13.87% and 3.63%.
2. There were 98 males and 50 females in the HPIV positive children, the ratio of male to female was 1.96:1. There was no significant difference in the HPIV1-4 detection rate between the sexes. HPIV3 and HPIV4 were found in 4 cases between 6 and 36 months old, most of them were children under 3 years old, especially children under 1 year old, 65.42%; HPIV4 was scattered in all age groups under 5 years old. Sixty cases (40.54%) were found to be mixed with other viruses, the most common of which were HBoV. HPIV1, 2, 3, 4 mixed with other viruses in 3 cases, 3 cases, 46 cases and 11 cases respectively.
3. The detection rate of HPIV 4 was the second in HPIV1-4, with two subtypes co-epidemic, mainly HPIV4a, the peak of epidemic in summer, all age groups under 5 years old, no gender difference, and similar clinical manifestations with HPIV3.
Conclusion:
1, HPIV4 is an important viral pathogen of ALRTI hospitalized children in Changsha.
2. There were two subtypes of HPIV4 epidemic in this study period. The main subtype was HPIV4a. The positive children were all under 5 years old, and there was no gender difference. The epidemic peak was in summer. The clinical characteristics of HPIV4 were similar to that of HPIV3.
3, the prevalence of HPIV1,2,3 in this study has its own characteristics.
【学位授予单位】：湖南师范大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.1
【参考文献】
相关期刊论文 前10条
1 段招军;黄灿平;瞿小旺;谢志萍;漆正宇;高寒春;彭夫望;刘文培;侯云德;;中国内陆发现HCoV-HKU1感染及N和S蛋白基因序列及进化分析[J];病毒学报;2006年04期
2 万凤国;张学兰;邵雪军;徐俊;丁云芳;;苏州地区急性呼吸道感染住院患儿病毒病原学分析[J];中国当代儿科杂志;2009年07期
3 肖霓光;张兵;段招军;谢志萍;周琼华;钟礼立;高寒春;丁小芳;曾赛珍;黄寒;侯云德;;1165例急性下呼吸道感染住院儿童的病毒病原学分析[J];中国当代儿科杂志;2012年01期
4 李军;朱启昒;俞蕙;顾新焕;;上海地区儿童急性下呼吸道常见病毒及鼻病毒感染的临床研究[J];临床儿科杂志;2007年06期
5 肖霓光;张兵;段招军;谢志萍;钟礼立;高寒春;丁小芳;李嘉;宋靖荣;刘震宇;黄寒;侯云德;;长沙地区急性下呼吸道感染住院儿童人博卡病毒感染的初步研究[J];临床儿科杂志;2011年06期
6 陆柔剑;谭文杰;阮力;;新型人冠状病毒HCoV-NL63和HCoV-HKU1的研究进展[J];生物技术通讯;2008年01期
7 张学兰;朱宏;邵雪军;季正华;丁云芳;季伟;严永东;;2001年至2008年苏州地区儿童急性呼吸道感染中腺病毒感染的流行趋势[J];苏州大学学报(医学版);2010年05期
8 何静;龚燕;张万菊;徐磊;刘yN;钱方兴;揭志军;俞慧菊;李杨;周志统;胡芸文;;2009～2010年上海地区急性呼吸道感染病毒病原谱分析[J];微生物与感染;2011年02期
9 季亚勇;沙丹;马广源;尤凤兴;居丽雯;施强;吴家林;凌霞;肖勇;;多重PCR和单重PCR在流感病毒快速检测中的比较与应用[J];现代预防医学;2010年04期
10 朱汝南,钱渊,邓洁,王芳,胡爱中,卢竞,曹力,袁艺,陈慧中;北京地区六岁以下儿童急性呼吸道偏肺病毒感染[J];中华儿科杂志;2003年06期
，本文编号：2215975
本文链接：https://www.wllwen.com/yixuelunwen/eklw/2215975.html
最近更新
教材专著
