目的 了解急性呼吸道感染(acute respiratory tract infection,ARI)患儿病毒感染病原分布状况,掌握浙江金华儿童病毒感染的病原学流行趋势,为儿童呼吸道病毒感染诊断提供帮助及临床治疗提供参考。方法 收集2013年2月-2014年1月本院住院确诊为急性呼吸道感染的1 200例患儿鼻咽分泌物,采用直接免疫荧光法(DFA)进行七项呼吸道病毒抗原检测,包括流感病毒A(FluA)和流感病毒B(FluB)、呼吸道合胞病毒(RSV)、腺病毒(ADV)及副流感病毒(PIV)1、2、3型,并进行统计学分析。结果 1 200例患儿送检标本,阳性424例(占35.33%)。阳性标本中RSV检出最高为290例(占68.40%)、FluA 26例(占6.13%)、FluB 10例(占2.36%)、ADV 12例(占2.83%)、PIV1 25例(占5.90%)、PIV2 6例(占1.42%)、PIV3 55例(占12.97%)。儿童呼吸道病毒感染第一至四季度检出率分别为41.27%、11.56%、12.74%及33.96%,第一与第四季度检出率较高且与第二、三季度相比有统计学差异(P＜0.05)。随着患儿年龄增长,呼吸道病毒感染率逐渐下降,0~6月龄婴幼儿病毒检出率最高(50.85%),3岁以上儿童病毒检出率最低(16.92%),且各年龄组间比较差异有统计学意义(P＜0.05)。结论 病毒是儿童急性呼吸道感染的主要病原,直接免疫荧光法检测不仅可以对临床提供快速、准确的诊断依据,还能及时为临床提供病原学资料,指导合理用药,防止抗生素滥用。

Objective To study the viral pathogens of acute respiratory tract infection (ARI) of children,to know the situation of respiratory virus epidemic of children in Wenling of Zhejiang Province,to assist the diagnosis of children's respiratory virus infection and to offer reference for clinical treatment. Methods A total of 1 200 nasopharyngeal secretion (NPS) samples were collected from ARI children who were hospitalized between February 2013 to January 2014.Direct immunofluorescence (DFA) was utilized to detect 7 respiratory viral antigens,including influenza virus A (FluA) and B (FluB),respiratory syncytial virus (RSV),adenovirus and parainfluenza viruses 1,2 and 3 (PIV1,PIV2 and PIV3).And then statistical analysis was performed. Results 424 virus infection in 1 200 cases of children with ARI were found,the positive rate was 35.33%.Among them,RSV in 290 cases accounted for 68.40% of positive cases,which listed the first;26 cases of FluA,accounted for 6.13%; 10 cases of FluB,accounted for 2.36%;12 cases of ADV,accounted for 2.83%; 22 cases of PIV1,accounted for 5.90%; 6 cases of PIV2,accounted for 1.42%; 55 cases of PIV3,accounted for 12.97% of the positive cases.The detection rate of respiratory viruses of children from the first quarter to the fourth quarter was 41.27%,11.56%,12.74% and 33.96%,respectively.The positive rates of the first and fourth quarter were higher than the second and third quarter,and there was a significant difference between them (P＜0.05).With the increase of age,respiratory virus infection rates gradually decreased in children,virus infection rate was 50.85% among the infants within 6 months,which listed the first.Whereas,the minimum virus infection rate was 16.92% among the children above 3 years old.And there was a significant differences among the groups (P＜0.05). Conclusions Respiratory viruses are the main pathogens in children with ARI.Using the direct immunofluorescence (DFA) can not only provide quick and accurate diagnostic basis but also can offer viral materials in clinic,guide the proper drug use and prevent the abuse of antibiotics.