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目的对2001至2005年苏州地区急性呼吸道感染儿童中呼吸道合胞病毒(RSV)进行流行病学监测,探讨 RSV 支气管肺炎患儿细胞免疫学变化。方法应用直接免疫荧光法对10 205份急性呼吸道感染患儿鼻咽分泌物进行 RSV 等7种病毒抗原检测;用流式细胞仪对其中30例(年龄1.5～24.0个月)RSV 支气管肺炎(支肺)患儿外周血进行 CD3、CD4、CD8、CD19、CD16及 CD56指标测定。设同龄健康对照15例(年龄1.5～24.0个月)。结果 2001至2005年苏州地区 RSV 年阳性率分别为:24.94%、25.83%、24.05%、25.39%、27.30%,5年中流行高峰在11月至翌年3月;1～12个月婴幼儿 RSV 阳性率超过12个月以上年龄组(x~2=97.320,P<0.01),12个月以内各组 RSV 阳性率差异也有统计学意义(x~2=7.804,P<0.05,3～6个月组阳性率最高);男性患儿 RSV 阳性率高于女性(x~2=9.693,P<0.01);RSV 支肺患儿 CD3~+、CD4~+、CD8~+、NK(CD16+56)~+细胞百分率均低于正常对照组(t=3.199,P<0.0l;t=2.215,P<0.05;t=2.619,P<0.05;t=5.240,P<0.01),CD19~+细胞百分率则高于正常对照组(t=2.875,P<0.01)。结论苏州地区 RSV 流行具有明显的季节性;年龄越小 RSV 感染率越高,RSV 支肺患儿细胞免疫功能低下,对低年龄婴幼儿 RSV 感染的有效预防尤为重要;男性患儿 RSV 感染率高于女性,其原因有待探讨。
Objective To investigate the epidemiological surveillance of respiratory syncytial virus (RSV) in children with acute respiratory infection in Suzhou from 2001 to 2005, and to investigate the changes of cellular immunity in children with RSV bronchopneumonia. Methods Nasopharyngeal secretions of 10 205 children with acute respiratory tract infection were detected by direct immunofluorescence. Seven kinds of virus antigens such as RSV were detected by flow cytometry. Thirty cases (1.5 ~ 24.0 months) of RSV bronchopneumonia Lung) children with peripheral blood CD3, CD4, CD8, CD19, CD16 and CD56 index determination. Fifteen healthy controls of the same age (age 1.5-24.0 months) were set up. Results The positive rates of RSV in Suzhou from 2001 to 2005 were 24.94%, 25.83%, 24.05%, 25.39% and 27.3% respectively. The prevalence of RSV in Suzhou was between November and March of the following year in March and from 1 to 12 months The positive rate was higher than 12 months old (x ~ 2 = 97.320, P <0.01). There was also a significant difference in the positive rate of RSV between each group within 12 months (x ~ 2 = 7.804, P <0.05, The positive rate of RSV in male patients was higher than that of female patients (x ~ 2 = 9.693, P <0.01). The CD3 +, CD4 +, CD8 +, NK ) ~ + Cells were lower than those in normal control group (t = 3.199, P <0.01; t = 2.215, P <0.05; The percentage was higher than the normal control group (t = 2.875, P <0.01). Conclusion RSV prevalence in Suzhou is obviously seasonal. The younger the younger, the higher the infection rate of RSV is, the lower immune function of children with RSV bronchial asthma is especially important for the prevention of RSV infection in infants and young children. The prevalence of RSV infection in male children is high For women, the reason remains to be explored.