2020年~2023年西安市儿童专科医院某科住院患儿呼吸道合胞病毒流行特征

Epidemiological Characteristics of Respiratory Syncytial Virus in Children Hospitalized in a Department of Xi’an Children’s Hospital from 2020 to 2023

摘要: 目的：了解西安市儿童医院呼吸一科因呼吸道感染住院患儿的呼吸道合胞病毒流行病学特征，为本地区呼吸道合胞病毒感染的临床诊疗及预防提供依据。方法：回顾性分析2020年1月1日~2023年12月31日，4年间因呼吸道合胞病毒感染在西安市儿童医院呼吸一科住院患儿为研究对象，并对结果进行分析。结果：纳入在西安市儿童医院呼吸一科住院的7363例呼吸道感染患者中呼吸道合胞病毒阳性病例628例，总阳性率为8.53%。RSV感染患儿在≤1岁年龄组检出率最高，占比为14.62% (333/2277)，随着年龄增加，阳性率也逐渐下降。不同性别患者的RSV阳性率差异无统计学意义(P > 0.05)。这4年期间，春季、夏季、秋季、冬季RSV的阳性检出率有明显差异，前3年RSV流行月份多在冬季，其次为秋季，但2023年间RSV流行月份多在春季，其次为夏季。在RSV感染阳性患儿中，不同年份的重症RSV感染患儿分布也具有明显差异性(P = 0.000 < 0.05)；不同月份RSV感染重症率比较差异无统计学意义(P = 0.163 > 0.05)；重症患者在≤1岁组比例最高，差异有统计学意义(P < 0.05)。RSV阳性感染患儿中，混合感染108例，合并单一病原体感染96例，双重病原体9例，3种病原体3例，混合感染中以肺炎支原体多见。RSV感染患儿常表现为咳嗽、喉间有痰，肺部体征以喘鸣音及湿啰音多见，最常见的合并症为心肌损害，偶有皮疹。结论：RSV是引起婴幼儿呼吸道感染常见的病原体，临床上应加强对婴幼儿的防护。

Abstract: Objective: To investigate the epidemiological characteristics of respiratory syncytial virus (RSV) in children with respiratory infection in Department 1 of Xi’an Children’s Hospital, and to provide evidence for clinical diagnosis, treatment and prevention of RSV infection in this area. Methods: From January 1, 2020 to December 31, 2023, children hospitalized with respiratory syncytial virus infection in Department 1 of Xi’an Children’s Hospital during 4 years were analyzed retrospectively, and the results were analyzed. Results: Among 7363 patients, 628 were positive for RSV, with a total positive rate of 8.53%. The highest rate of RSV infection was in the age group ≤1 year, accounting for 14.62% (333/2277), and the positive rate decreased gradually with the increase of age. There was no significant difference in the positive rate of RSV among different genders (P > 0.05). During the four years, the positive detection rates of RSV from March to May, June to August, September to November, and December to February of the same year were significantly different. In the first three years, the prevalence months of RSV were mostly from December to February, followed by September to November, but in 2023, the prevalence months of RSV were mostly from March to May, and the three times were from June to August. Among RSV positive children, the distribution of severe RSV infection in different years was also significantly different (P = 0.000 < 0.05). There was no significant difference in the severity rate of RSV infection in different months (P = 0.163 > 0.05). The proportion of severe cases in ≤1 year old group was the highest, and the difference was statistically significant (P < 0.05). There were 108 cases of mixed infection with RSV-positive infection, 96 cases with single pathogen, 9 cases with double pathogen, and 3 cases with 3 pathogens. Mycoplasma pneumoniae was the most common mixed infection. Children with RSV infection often present cough, phlegm in the throat, and pulmonary signs are mostly wheezing and moist rales. The most common comorbidities are myocardial damage and occasional rash. Conclusion: RSV is a common pathogen causing respiratory tract infection in infants and young children, and the clinical protection should be strengthened.