人博卡病毒载量与儿童急性下呼吸道感染临床特征相关性研究

Relationship between viral load of human bocavirus and clinical characteristics in children with acute lower respiratory tract infection

摘要:

目的 了解人类博卡病毒 （HBoV）在儿童急性下呼吸道感染中的检出情况，并探讨HBoV载量与儿童急性下呼吸道感染临床特征的相关性。方法 收集2011年3月至2014年3月因急性下呼吸道感染住院患儿的鼻咽抽吸物 （NPAs）1 554份，采用实时荧光定量PCR检测12种RNA病毒和ADV、HBoV 2种DNA病毒，并同时检测HBoV阳性患儿的病毒载量。结果 1 554份标本中1 212份 （77.99%）检出病毒，275份 （17.70%）HBoV检出阳性。HBoV阳性病例中 < 3岁者占94.9%，男性多于女性。275例HBoV阳性病例中，单一感染45例 （16.36%），混合感染230例 （83.64%），两者病毒载量的差异无统计学意义 （P > 0.05）。有发热症状的HBoV阳性患儿病毒载量高于无发热者，有喘息症状的病毒载量高于无喘息者，差异均有统计学意义 （P < 0.05）。轻、中、重度组急性下呼吸道感染患儿之间的病毒载量差异无统计学意义 （P > 0.05）。结论 HBoV是儿童急性下呼吸道感染重要病原之一。病毒载量高的患儿，临床更易出现发热、喘息等症状，但疾病严重程度及混合感染与病毒载量之间无显著相关性。

Abstract:

Objective To investigate the prevalence of human bocavirus (HBoV) in children with acute lower respiratory tract infection and to explore the relationship between the viral load of HBoV and the clinical characteristics of acute lower respiratory tract infection in children. Methods A total of 1 554 nasopharyngeal aspirates from children who were hospitalized due to acute lower respiratory tract infection between March 2011 and March 2014 were collected. Quantitative real-time PCR was used to detect 12 RNA and 2 DNA viruses, adenovirus (ADV) and HBoV, and to measure the viral load of HBoV in HBoV-positive children. A comprehensive analysis was performed with reference to clinical symptoms and indicators. Results In the 1 554 specimens, 1 212 (77.99%) were positive for viruses, and 275 (17.70%) were HBoV-positive. In HBoV-positive cases, 94.9% were aged < 3 years, and there were more males than females. In the 275 HBoV-positive cases, 45 (16.36%) had single infection, and 230 (83.64%) had mixed infection. There was no significant difference in viral load between children with single infection and mixed infection (P > 0.05). The patients with fever had a significantly higher viral load than those without fever (P < 0.05). The children with wheezing had a significantly higher viral load than those without wheezing (P < 0.05). There was no significant difference in viral load between children with mild, moderate, and severe acute lower respiratory tract infection (P > 0.05). Conclusions HBoV is one of the important pathogens of acute lower respiratory tract infection in children. Children with a higher viral load of HBoV are more likely to experience symptoms such as fever and wheezing. However, the severity of disease and mixed infection are not significantly related to viral load.