
人博卡病毒载量与儿童急性下呼吸道感染临床特征相关性研究
丁小芳, 张兵, 钟礼立, 谢乐云, 肖霓光
中国当代儿科杂志 ›› 2017, Vol. 19 ›› Issue (3) : 327-330.
人博卡病毒载量与儿童急性下呼吸道感染临床特征相关性研究
Relationship between viral load of human bocavirus and clinical characteristics in children with acute lower respiratory tract infection
目的 了解人类博卡病毒 (HBoV)在儿童急性下呼吸道感染中的检出情况,并探讨HBoV载量与儿童急性下呼吸道感染临床特征的相关性。方法 收集2011年3月至2014年3月因急性下呼吸道感染住院患儿的鼻咽抽吸物 (NPAs)1 554份,采用实时荧光定量PCR检测12种RNA病毒和ADV、HBoV 2种DNA病毒,并同时检测HBoV阳性患儿的病毒载量。结果 1 554份标本中1 212份 (77.99%)检出病毒,275份 (17.70%)HBoV检出阳性。HBoV阳性病例中 < 3岁者占94.9%,男性多于女性。275例HBoV阳性病例中,单一感染45例 (16.36%),混合感染230例 (83.64%),两者病毒载量的差异无统计学意义 (P > 0.05)。有发热症状的HBoV阳性患儿病毒载量高于无发热者,有喘息症状的病毒载量高于无喘息者,差异均有统计学意义 (P < 0.05)。轻、中、重度组急性下呼吸道感染患儿之间的病毒载量差异无统计学意义 (P > 0.05)。结论 HBoV是儿童急性下呼吸道感染重要病原之一。病毒载量高的患儿,临床更易出现发热、喘息等症状,但疾病严重程度及混合感染与病毒载量之间无显著相关性。
Objective To investigate the prevalence of human bocavirus (HBoV) in children with acute lower respiratory tract infection and to explore the relationship between the viral load of HBoV and the clinical characteristics of acute lower respiratory tract infection in children. Methods A total of 1 554 nasopharyngeal aspirates from children who were hospitalized due to acute lower respiratory tract infection between March 2011 and March 2014 were collected. Quantitative real-time PCR was used to detect 12 RNA and 2 DNA viruses, adenovirus (ADV) and HBoV, and to measure the viral load of HBoV in HBoV-positive children. A comprehensive analysis was performed with reference to clinical symptoms and indicators. Results In the 1 554 specimens, 1 212 (77.99%) were positive for viruses, and 275 (17.70%) were HBoV-positive. In HBoV-positive cases, 94.9% were aged < 3 years, and there were more males than females. In the 275 HBoV-positive cases, 45 (16.36%) had single infection, and 230 (83.64%) had mixed infection. There was no significant difference in viral load between children with single infection and mixed infection (P > 0.05). The patients with fever had a significantly higher viral load than those without fever (P < 0.05). The children with wheezing had a significantly higher viral load than those without wheezing (P < 0.05). There was no significant difference in viral load between children with mild, moderate, and severe acute lower respiratory tract infection (P > 0.05). Conclusions HBoV is one of the important pathogens of acute lower respiratory tract infection in children. Children with a higher viral load of HBoV are more likely to experience symptoms such as fever and wheezing. However, the severity of disease and mixed infection are not significantly related to viral load.
Human bocavirus / Acute lower respiratory tract infection / Viral load / Child
[1] Johnston SL. Overview of virus-induced airway disease[J]. Proc Am Thorac Soc, 2005, 2(2):150-156.
[2] Allander T, Tammi MT, Eriksson M, et al. Cloning of a human parvovirus by molecular screening of respiratory tract samples[J]. Proc Natl Acad Sci U S A, 2005, 102(36):12891-12896.
[3] Arnold JC. Human bocavirus in children[J]. Pediatr Infection Dis J, 2010, 29(6):557-558.
[4] Jartti T, Hedman K, Jartti L, et al. Human bocavirus-the first 5 years[J]. Rev Med Virol, 2012, 22(1):46-64.
[5] Allander T, Jartti T, Gupta S, et al. Human bocavirus and acute wheezing in children[J]. Clin Infect Dis, 2007, 44(7):904-910.
[6] Arden KE, McErlean P, Nissen MD, et al. Frequent detection of human rhinoviruses, paramyxoviruses, coronaviruses, and bocavirus during acute respiratory tract infections[J]. J Med Virol, 2006, 78(9):1232-1240.
[7] Urši? T, Krivec U, Kalan G, et al. Fatal human bocavirus infection in an 18-month-old child with chronic lung disease of prematurity[J]. Pediatr Infect Dis J, 2015, 34(1):111-112.
[8] Krakau M, Gerbershagen K, Frost U, et al. Case report:human bocavirus associated pneumonia as cause of acute injury, Cologne, Germany[J]. Medicine (Baltimore), 2015, 94(42):e1587.
[9] Zhao B, Yu X, Wang C, et al. High human bocavirus viral load is associated with disease severity in children under five years of age[J]. PLoS One, 2013, 8(4):e62318.
[10] Jiang W, Yin F, Zhou W, et al. Clinical significance of different virus load of human bocavirus in patients with lower respiratory tract infection[J]. Sci Rep, 2016, 6:20246.
[11] 申昆仑, 江载芳.呼吸系统疾病[M]//胡亚美, 江载芳, 诸福棠. 实用儿科学上册. 第7版. 北京:人民卫生出版社, 2002, 1171-1214.
[12] Proenca-Modena JL, Gagliardi TB, Escremde Paula F, et al. Detection of human bocavirus mRNA in respiratory secretions correlates with high viral load and concurrent diarrhea[J]. PLoS One, 2011, 6(6):e21083.
[13] Walsh EE, McConnochie KM, Long CE, et al. Severity of respiratory syncytial virus infection is related to virus strain[J]. J Infect Dis, 1997, 175:814-820.
[14] Kantola K, Sadeghi M, Antikainen J, et al. Real-time quantitative PCR detection of four human bocaviruses[J]. J Clin Microbiol, 2010, 48(11):4044-4050.
[15] Edner N, Castillo-Rodas P, Falk L, et al. Life-threatening respiratory tract disease with human bocavirus-1 infection in a 4-year-old child[J]. J Clin Microbiol, 2012, 50(2):531-532.
[16] 肖霓光, 张兵, 段招军, 等. 长沙地区急性下呼吸道感染住院儿童人博卡病毒感染的初步研究[J]. 临床儿科杂志, 2011, 29(6):510-513.
[17] Kim JS, Lim CS, Kim YK, et al. Human bocavirus in patients with respiratory tract in fection[J]. Korean J Lab Med, 2011, 31(3):179-184.
[18] 尹芳, 周卫芳, 王美娟, 等. 人类博卡病毒载量与儿童呼吸道感染临床特征的相关性[J]. 中国传染病杂志, 2014, 32(6):343-348.
[19] Zhou L, Zheng S, Xiao Q, et al. Single detection of human bocavirus 1 with a high viral load in severe respiratory tract infections in previously healthy children[J]. BMC Infect Dis, 2014, 14:424.
[20] 林创兴, 陆学东, 林广裕, 等. 儿科重症监护病房患儿博卡病毒感染的临床分析[J]. 国际儿科学杂志, 2014, 41(4):424-426.
[21] 朱利华, 许会卿, 覃世榕, 等. 儿童急性呼吸道博卡病毒感染的病毒载量与临床特征相关性研究[J]. 中华实验和临床病毒学杂志, 2011, 25(4):271-273.
国家科技重大专项项目(2014ZX10004002-007-004)。