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中国循证儿科杂志

中国循证儿科杂志 ›› 2020, Vol. 15 ›› Issue (5): 361-364.

• 论著 • 上一篇    下一篇

2018至2019年上海市腺病毒感染患儿发病趋势和临床特征的横断面调查

李小玲1,2,10，祁媛媛1,2,10，施鹏1,3,9，叶颖子1,4,9，黄国英1,5,9，徐虹1,6,9，陈超1,7,9，桂永浩1,8,9，张晓波1,2,9   

  1. 1 复旦大学附属儿科医院 上海，201102，2 呼吸科，3 统计和数据管理中心，4 感染科，5 心内科，6 肾脏科，7 新生儿科，8 卫生部新生儿疾病重点实验室，9 上海市儿科临床质量控制中心；10 共同第一作者
  • 收稿日期:2020-05-09 修回日期:2020-10-16 出版日期:2020-10-25 发布日期:2020-10-25
  • 通讯作者: 张晓波

The incidence trend and clinical characteristics of children with adenovirus infection in Shanghai from 2018 to 2019: A cross-sectional survey

LI Xiaoling1,2,10, QI Yuanyuan1,2,10, SHI Peng1,3,9, YE Yingzi1,4,9, HUANG Guoying1,5,9, XU Hong1,6,9, CHEN Chao1,7,9, GUI Yonghao1,8,9, ZHANG Xiaobo1,2,9   

  1. 1 Children's Hospital of Fundan University, Shanghai 201102, China, 2 Respiratory Department, 3 Department of Statistics and Data Management Center, 4 Department of Infectious Diseases, 5 Department of Cardiology, 6 Department of Nephrology, 7 Department of Neonatology, 8 Key Laboratory of Neonatal DiseasesMinistry of Health, 9 Shanghai Pediatric Clinical Quality Control Center; 10 Co-first author
  • Received:2020-05-09 Revised:2020-10-16 Online:2020-10-25 Published:2020-10-25
  • Contact: ZHANG Xiaobo

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摘要： 目的：描述上海市医疗机构腺病毒感染患儿发病趋势和临床特征。方法：横断面调查。收集2018年1月1日至2019年5月31日上海市38家医疗机构门、急诊就诊和住院的腺病毒感染患儿的人口学特征、临床诊断、病毒学检测等信息，比较2019与2018年同期（1~5月）腺病毒感染患儿的临床特征。结果：618例腺病毒感染患儿进入本文分析，16例(2.6%)入住PICU，无死亡病例。门、急诊患儿298例(48.2%)，男176例(59.1%),腺病毒肺炎104例(34.9%)。住院患儿320例，男204例(63.8%),腺病毒肺炎278例（86.9%）。在2018年1月和2019年1月门、急诊腺病毒感染患儿均出现感染高峰，2018年1月后感染峰值迅速下降，2019年1~5月感染峰值虽有所下降但仍维持在较高水平; 2019较2018年同期（1~5月）门、急诊和住院患儿腺病毒感染分别增长1.8倍（148/84）和2.3倍（157/69）；门、急诊就诊患儿中， 2019较2018年同期（1~5月）就诊急诊比例增高(37.2% vs 9.5%)、平均年龄（岁）更小（3.0 vs 4.0），<2岁患儿比例增高，腺病毒肺炎比例增高（50.0% vs 13.1%），差异均有统计学意义（P<0.05）。儿童专科医院腺病毒检测方法主要为深部痰液抗原检测、鼻拭子腺病毒抗原快速检测和血清抗体IgM检测；综合医院腺病毒检测方法主要为鼻拭子腺病毒抗原快速检测和血清抗体IgM检测。结论：2019较2018年同期（1~5月）上海市腺病毒感染呈现高发趋势且至少持续至5月，腺病毒肺炎比例高，<2岁患儿比例高。

Abstract: ObjectiveTo describe the incidence trend and clinical characteristics of children with adenovirus infection in medical institutions in Shanghai. MethodsA cross-sectional study was designed to collect the demographic characteristics, clinical diagnosis and virological detection of children with adenovirus infection in outpatient and emergency settings and hospitalization in 38 medical institutions in Shanghai from January 1st, 2018 to May 31st, 2019，and compare the clinical characteristics of children with adenovirus infection in the same period of 2019 and 2018 (from January to May). ResultsA total of 618 children with adenovirus infection were included in this analysis. Sixteen patients (2.6%) were admitted to PICU and there were no deaths. There were 298 children with adenovirus positive detected in outpatient and emergency settings, including 176 male cases (59.1%) and 104 adenovirus pneumonia cases (34.9%). There were 320 hospitalized children, including 204 male cases (63.7%) and 278 adenovirus pneumonia cases (86.9%). In January of 2018 and 2019, the number of children with adenovirus infection in outpatient and emergency settings reached its peak. After January 2018, the peak of infection dropped rapidly, and from January to May in 2019 the peak decreased but still remained at a relatively high level. In 2019, compared with the same period in 2018 (from January to May), the incidence of pediatric adenovirus infection in outpatient and emergency settings and hospitalization increased by 1.8 times (148/84) and 2.3 times (157/69), respectively; the proportion of emergency visits increased (37.2% vs 9.5%); the mean age was younger (3.0 vs 4.0); the proportion of children under 2 years old was higher; the proportion of adenovirus pneumonia increased (50.0% vs 13.0%). There were statistically significant differences (P<0.05). Adenovirus detection methods in children's specialized hospital mainly include deep sputum antigen detection, the rapid detection of nasal swab antigen and serum IgM antibody detection. The detection methods of adenovirus in general hospital mainly include the rapid detection of nasal swab antigen and serum IgM antibody detection. ConclusionCompared with the same period of 2018 (from January to May), the incidence of adenovirus infection in Shanghai showed a higher trend in 2019 and lasted until May at least, with a higher proportion of adenovirus pneumonia and adenovirus infection in children under 2 years old.