重庆地区呼吸道感染患儿甲型流感与新型甲型H1N1流感病毒检测及临床特征分析

发布时间：2018-09-10 18:33

【摘要】：目的： 了解重庆地区呼吸道感染患儿甲型流感(Influenza A virus, IVA)与新型甲型H1N1流感病毒(Swine-origin influenza A H1N1virus,S-OIVs)流行情况、临床特征,并探讨IVA感染后发展为重症肺炎的危险因素。 方法： 收集重庆医科大学附属儿童医院呼吸一病房住院的呼吸道感染患儿的鼻咽抽吸物1074例,时间从2009年6月至2011年5月。采用Real-Time RT-PCR技术定性检测标本中甲型流感及新型甲型H1N1流感病毒RNA, S-OIVs阳性标本扩增产物、测序,结果与Genebank中序列进行比较以明确,并结合临床资料进行分析。使用SPSS17.0软件进行统计分析。 结果： 1. IVA/S-OIVs阳性检出率：标本总数1074份,检出IVA阳性105例(包含S-OIVs阳性15例),阳性率9.8%,检出S-OIVs阳性15例,阳性率1.4%。 2.IVA/S-OIVs感染流行病学特点：IVA阳性105例,男性72例,女性33例,男：女=2.2：1；年龄1～135月,≤5岁检出阳性97例(92.4%),其中≤2岁检出阳性81例(77.1%),以春、夏季节感染为主。15例S-OIVs感染患儿中男性12例,女性3例,男：女=4：1；年龄1～63月,≤5岁阳性检出13例(86.7%),其中≤2岁阳性检出12例(80%),以夏季感染为主。 3.IVA/S-OIVs感染临床特点：IVA/S-OIVs感染主要引起肺炎。IVA/S-OIVs感染患儿大部分伴有发热、咳嗽、咳痰症状,1/3伴有喘息,肺部体征以湿罗音居多。IVA/S-OIVs感染后外周血白细胞计数及C反应蛋白多不升高,淋巴细胞分类为主。IVA混合感染其他常见呼吸道病毒48份(45.796)；S-OIVs混合感染其他常见呼吸道病毒9份(60.0%)。两者最常见的混合感染均是PIV3。 4.IVA感染后发展为重症肺炎的相关危险因素：重症肺炎15例,男性9例,女性6例。病毒混合感染(P=0.027;OR=3.939;OR95%CI,1.164～13.329)、肺炎克雷伯氏菌痰培养(+)(P=0.023；OR=7.250; OR95%CI,1.311～40.098)或合并先天性心脏病(P=0.010:OR=8.533; OR95%CI,1.658～43.929)是IVA感染后引起重症肺炎的相关危险因素。 结论： 1.重庆地区呼吸道感染住院患儿IVA感染率为9.8%,S-OIVs感染率为1.4%。2岁以下儿童为主要易感人群,夏、春季为流行高峰季节。 2. IVA/S-OIVs感染后临床表现无明显特异性。IVA混合其他常见呼吸道病毒感染率为45.7%,S-OIVs混合其他常见呼吸道病毒感染率为60.0%。PIV3为两者混合感染最常见病毒。 3.混合呼吸道其他常见病毒感染、肺炎克雷伯氏菌痰培养(+)或合并先天性心脏病是IVA感染后发展为重症肺炎的相关危险因素。
[Abstract]:Objective: to investigate the prevalence and clinical characteristics of influenza A (Influenza A virus, IVA) and new type A H1N1 influenza virus (Swine-origin influenza A H1 N 1 virus S OIVs) in children with respiratory tract infection in Chongqing, and to explore the risk factors for the development of severe pneumonia after IVA infection. Methods: from June 2009 to May 2011, 1074 cases of nasopharynx aspiration were collected from the respiratory ward of the Children's Hospital affiliated to Chongqing Medical University. Real-Time RT-PCR technique was used to qualitatively detect the amplification products of RNA, S-OIVs positive samples of influenza A and new type A H1N1 influenza virus. The results were compared with those in Genebank, and the results were analyzed in combination with clinical data. Use SPSS17.0 software for statistical analysis. Results: 1. The positive rate of IVA/S-OIVs: there were 1074 samples, 105 cases were positive for IVA (including 15 cases of S-OIVs), the positive rate was 9.8, the positive rate was S-OIVs in 15 cases, the positive rate was 1.40.Epidemiological characteristics of 2.IVA/S-OIVs infection, including 72 cases of male and 33 cases of female, were positive in 10 5 cases of 2.IVA/S-OIVs infection. Male: female: 2.2: 1, age 1 ~ 135 months, 97 cases (92.4%) were positive in 鈮，

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