人鼻病毒C型在呼吸道感染住院患儿中的流行病学研究

An epidemiological study on human rhinovirus C in hospitalized children with respiratory tract infections

摘要:

目的 了解苏州地区人鼻病毒C型 （HRV-C）在呼吸道感染 （RTIs）住院患儿中的检出情况、流行特点及临床特征。方法 选取2014年1~12月RTIs住院患儿1702例为研究对象，采集所有患儿鼻咽深部吸取物1702份。采用RT-PCR法检测HRVmRNA；实时荧光定量PCR+高分辨熔链曲线分析对HRV-C进行检测。结果 1702例RTIs患儿中，检出HRV感染244例 （14.34%），其中HRV-C型69例 （69/244，28.3%）。HRV-C混合感染率为61% （42/69）。HRV-C在每个月份均有检出，其中秋季阳性检出率显著高于春、夏、冬三季 （P < 0.05）；2~5岁患儿HRV-C检出率显著高于其他年龄组 （P < 0.05）。HRV-C感染致大叶性肺炎和哮喘急性发作的比例显著高于HRV-A/B感染 （P < 0.05）；HRV-C感染所致中性粒细胞、CRP升高比例显著高于HRV-A/B感染 （P < 0.05），但在性别分布和其他临床表现上差异均无统计学意义 （P > 0.05）。结论 HRV-C感染约占HRV感染的1/3，秋季高发，混合感染率高，以2~5岁患儿检出率最高，HRV-C感染患儿的临床表现基本与HRV-A/B感染患儿相似。

Abstract:

Objective To investigate the detection rates, epidemical characteristics, and clinical features of human rhinovirus C (HRV-C) in hospitalized children with respiratory tract infections (RTIs) in Suzhou, China. Methods A total of 1 702 hospitalized children with RTIs from January to December, 2014 were enrolled, and 1 702 nasopharyngeal aspirate samples were collected from all children. RT-PCR was used to measure HRV mRNA, and quantitative realtime PCR combined with high-resolution melting curve was used to measure HRV-C. Results Of all children, 244 (14.34%) were detected to have HRV infection, among whom 69 (69/244, 28.3%) had HRV-C infection. The rate of mixed infection of HRV-C with other viruses and bacteria was 61% (42/69). HRV-C was detected in each month of the year, and the detection rate of HRV-C in autumn was significantly higher than that in spring, summer, and winter (P < 0.05). The children aged 2-5 years had a significantly higher detection rate of HRV-C than those in the other age groups (P < 0.05). Compared with HRV-A/B infection, HRV-C infection led to significantly higher proportions of patients with lobar pneumonia and acute exacerbation of asthma (P < 0.05), as well as patients with increased neutrophil count and CRP level (P < 0.05). There were no significant differences in sex distribution or other clinical manifestations (P > 0.05). Conclusions HRV-C infection accounts for about 1/3 of HRV infection, with a high incidence rate in autumn. The rate of mixed infection of HRV-C with other viruses and bacteria is high, and children aged 2-5 years have the highest detection rate of HRV-C. Children with HRV-C infection have similar clinical manifestations as those with HRV-A/B infection.