急性下呼吸道感染住院兒童病毒譜調(diào)查及人副流感病毒1-4型的現(xiàn)狀分析
發(fā)布時(shí)間：2018-08-31 19:42
【摘要】：第一部分2010-2011年長(zhǎng)沙地區(qū)急性下呼吸道感染住院兒童病毒譜調(diào)查 目的： 了解2010～2011年長(zhǎng)沙地區(qū)急性下呼吸道感染(acute low respiratory tract infection, ALRTI)住院兒童常見呼吸道病毒的流行病學(xué)特點(diǎn),為本地區(qū)兒童ALRTI的防治提供參考資料。方法： 1、收集2010年3月～2011年2月在湖南省人民醫(yī)院暨湖南師范大學(xué)第一附屬醫(yī)院兒科醫(yī)學(xué)中心因ALRTI住院的兒童鼻咽抽吸物(Nasopharyngeaaspirates samples, NPAs)標(biāo)本。 2、采用PCR方法檢測(cè)ADV, RT-PCR方法檢測(cè)HPIV3、RSV、 HRV、IFVA、B、HMPV、HCoV-NL63、HCoV-HKUl、Nest-PCR方法檢測(cè)HPIV1、HPIV2、HPIV4、HBoV,并對(duì)陽(yáng)性擴(kuò)增產(chǎn)物進(jìn)行基因測(cè)序,所得結(jié)果與美國(guó)國(guó)立生物技術(shù)中心(NCBI) GeneBank中的序列進(jìn)行BLAST比對(duì)證實(shí)。 3、對(duì)各種病毒在兒童ALRTI中的流行病學(xué)特點(diǎn)進(jìn)行分析。結(jié)果： 1、2010年3月～2011年2月共收集771例患兒的NPAs標(biāo)本,711份NPAs標(biāo)本中有536份檢出病毒,總檢出率為69.52%(536/771),位居前三位的是HRV、RSV、HPIV3;之后依次為HBoV、ADV、 HMPV、HPIV4、IFVB、IFVA、HPIV1、HCoV-HKU1、HCoV-NL63、 HPIV2和HBoV2。 2、檢出病毒的536例患兒中,男性檢出354例(72.09%),女性檢出182例(65.00%),男女陽(yáng)性檢出率之比為1.94：1,男性居多,男女之間比較差異有統(tǒng)計(jì)學(xué)意義(x2=4.239,P=0.039)。14種病毒男女之間陽(yáng)性檢出率比較無(wú)統(tǒng)計(jì)學(xué)差異。 3、納入研究的患兒年齡在0-14歲之間,平均23.65個(gè)月。病毒陽(yáng)性檢出在5歲以下患兒中占95.70%,3歲以下占80.59%。病毒檢出率在各年齡段之間比較有統(tǒng)計(jì)學(xué)差異(x2=40.968,P=0.000)；其中RSV、IFVA、IFVB、HPIV3和ADV陽(yáng)性檢出率在年齡段分布上比較有統(tǒng)計(jì)學(xué)差異,其余病毒無(wú)差異。 4、在研究期間內(nèi),病毒檢出率在季節(jié)分布上有統(tǒng)計(jì)學(xué)差異(x2=22.211,P=0.000),以春季檢出率最高；不同病毒陽(yáng)性檢出率的季節(jié)分布有不同,RSV在冬季檢出率最高,其次為春季；HRV和ADV均在秋季有一個(gè)檢出率高峰；HBoV1和HPIV3在春夏季檢出為主,尤其是夏季更多；HPIV4夏季為多；IFVB和HMPV的檢出高峰均為春季；IFVA和HCoV-HKU1僅在夏秋季有檢出。 結(jié)論： 1、本研究期間內(nèi)ALRTI住院兒童病毒檢出率為69.52%,表明病毒在長(zhǎng)沙地區(qū)兒童ALRTI中仍占有重要地位。 2、本研究期電ALRTI住院兒童病毒譜構(gòu)成前三位的是HRV、RSV、PIV3,ADV檢出率較往年明顯增高。 3、本資料中3歲以下患兒病毒檢出占80.59%；在各年齡段之間病毒檢出率有統(tǒng)計(jì)學(xué)差異,不同病毒有各自的年齡分布特點(diǎn)；病毒檢出男性居多；春季檢出率最高,不同病毒也有各自季節(jié)分布特點(diǎn)。 第二部分人副流感病毒1-4型在長(zhǎng)沙地區(qū)急性下呼吸道感染住院兒童中的現(xiàn)狀分析 目的： 了解HPIV1、2、3、4型在長(zhǎng)沙地區(qū)ALRTI住院兒童中的流行病學(xué)特點(diǎn),探討HPIV4在本地區(qū)ALRTI兒童中的流行狀況、臨床特點(diǎn)以及與其他HPIV之間的差異,為進(jìn)一步研究奠定基礎(chǔ)。 方法： 1、收集2010年3月～2011年2月在湖南省人民醫(yī)院暨湖南師范大學(xué)第一附屬醫(yī)院兒科醫(yī)學(xué)中心因ALRTI住院兒童NPAs標(biāo)本。 2、采用Nest-PCR方法檢測(cè)HPIV1-4型,并對(duì)擴(kuò)增產(chǎn)物進(jìn)行測(cè)序,所得測(cè)序結(jié)果與美國(guó)國(guó)立生物技術(shù)中心(NCBI) GeneBank中的序列進(jìn)行BLAST比對(duì)分析,并采用MEGA4軟件對(duì)序列進(jìn)行分析并繪制進(jìn)化樹。 3、對(duì)HPIV4與其它型別HPIV在兒童ALRTI中的流行病學(xué)和臨床特點(diǎn)進(jìn)行比較和分析。 結(jié)果： 1、本研究771例NPAs標(biāo)本中共檢出HPIV148例,檢出率為19.19%(148/771); HPIV1、HPIV2、HPIV3、HPIV4型分別檢出12例、4例、107例和28例,檢出率分別為1.55%、0.51%、13.87%和3.63%。 2、HPIV陽(yáng)性檢出患兒中男性98例,女性50例,男女檢出率之比為1.96：1。HPIV1-4型檢出率性別間比較均無(wú)統(tǒng)計(jì)學(xué)差異。HPIV陽(yáng)性檢出患兒年齡均在5歲之內(nèi),主要集中在1歲以下；其中,HPIV1在6個(gè)月以下年齡段無(wú)檢出,1-3歲之間檢出率稍高；]HPIV2僅在6-36個(gè)月之間檢出4例；HPIV3以3歲以內(nèi)患兒為主,特別是1歲以內(nèi)的兒童占65.42%；HPIV4在5歲以下的各年齡段散在分布。僅HPIV3的檢出率在各年齡段之間比較有統(tǒng)計(jì)學(xué)差異(X2=29.648,P=0.000)。HPIV3和HPIV4均在夏季檢出率最高。單一檢出HPIV陽(yáng)性88例,與其它病毒的混合檢出60例(40.54%),其中最多見為HBoV。HPIV1、2、3、4與其他病毒混合檢出分別為3例、3例、46例和11例。 3、HPIV4的檢出率在HPIV1-4型中居第二位,有兩個(gè)亞基因型共同流行,以HPIV4a為主；夏季為流行高峰；在5歲以下的各年齡段均有檢出；無(wú)性別間差異；臨床表現(xiàn)與HPIV3類似。 結(jié)論： 1、HPIV4是長(zhǎng)沙地區(qū)ALRTI住院兒童的重要病毒病原。 2、本研究期間內(nèi)]HPIV4有兩個(gè)亞基因型流行,以HPIV4a為主,陽(yáng)性檢出患兒均在5歲以下,無(wú)性別間差異,夏季為流行高峰,臨床特點(diǎn)與HPIV3類似。 3、本研究期間HPIV1、2、3的流行狀況有各自特點(diǎn)。
[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.
【學(xué)位授予單位】：湖南師范大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R725.1
本文編號(hào)：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.
【學(xué)位授予單位】：湖南師范大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R725.1
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