本文選題：兒童 + 呼吸道感染　； 參考：《重慶醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的 分析比較重慶地區(qū)兒童常見呼吸道病毒感染的流行特征及致病情況。 方法 回顧性分析2009年1月～2011年12月入住呼吸科病房的住院患兒流行病學(xué)資料，共19452例。入院當(dāng)日抽取鼻咽部分泌物，采用直接免疫熒光法檢測7種常見呼吸道病毒，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）。 結(jié)果 1、病毒陽性者為9387例，總陽性率為48.26%；7種常見呼吸道病毒的檢出陽性率分別為RSV29.23%、ADV3.98%、IVA2.54%、IVB0.48%、PIV11.95%、PIV20.25%，PIV39.83%。 2、混合感染者604例，混合感染率為3.11%。RSV合并其他病毒混合感染為516例，占混合感染的85.43%（516/604），其中RSV+PIV3為238例，占總混合感染的39.40%（238/604）�；旌细腥韭试�11月、12月、1月及2月份常見。 3、RSV感染高峰在每年12月及1月，其次為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月份多見。ADV在每年4—7月份有感染高峰，其中5、6月份為最高值，而11月份及12月份則少見。流感病毒中，IVA總陽性率為2.54%（495/19452），IVB總陽性率為0.47%（92/19452）。PIV1在2009年中9月—12月多見，2010年及2011年在2月—5月份多見。PIV2在2009年9月、2010年4月及2011年3、8月相對多見。 4、不同性別、年齡及季節(jié)病毒感染差異有統(tǒng)計學(xué)意義。5、2009年6341例患兒中，病毒總感染例數(shù)2652例，陽性率為41.82%。毛細(xì)支氣管炎患兒病毒陽性率71.41%，其病毒構(gòu)成比中RSV為82.72%。毛細(xì)支氣管炎、肺炎、支氣管炎及喉氣管支氣管炎患兒中RSV、PIV3及IVA為其病毒病原感染前3位。在上呼吸道感染中居前3位的病毒病原為腺病毒（ADV）、流感病毒A（IVA）及副流感病毒3型（PIV3）。 結(jié)論 1、病毒仍是呼吸道感染性疾病的主要病原，7種呼吸道常見病毒中RSV仍居于呼吸道感染病毒病原的首位，，PIV3次之，再次為ADV。從高到低順序為RSV＞PIV3＞ADV＞IVA＞PIV1＞IVB＞PIV2。 2、混合感染在冬季多見；RSV合并其他病毒感染占混合感染的絕大多數(shù)，尤其是RSV+PIV。 3、RSV、ADV及PIV3具有明顯的流行特征；RSV感染秋冬季多見，ADV及PIV3以春夏季多見，其余4種病毒感染無明顯流行特征。 4、病毒感染與性別、年齡及季節(jié)有關(guān)。 5、在下呼吸道感染中，RSV、PIV3及IVA為主要病毒病原，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.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R725.6

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