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目的了解北京地区急性呼吸道感染婴幼儿中人偏肺病毒(hMPV)的感染情况。方法采集2004年7月至2006年6月首都儿科研究所附属儿童医院门诊和住院呼吸道感染患儿的咽拭子和鼻咽洗液临床标本3330份,进行细胞培养和间接免疫荧光检测病毒;同时提取标本中病毒RNA后经逆转录聚合酶链反应扩增位于hMPV M基因的片段,经琼脂糖凝胶电泳检测扩增片段。结果从3330份临床标本中检测到110份hMPV阳性标本,阳性率3.3%。hMPV感染的患儿男女比例为1.5:1,其中<1岁年龄组患儿占46.4%(51/110),1～岁年龄组患儿占11.8%(13/110),2～5岁年龄组患儿占33.6%(37/110),>5岁年龄组患儿占8.2%(9/110)。hMPV感染患儿的临床症状以肺炎占的比例最大,为44.5%(49/110);其次是诊断为上呼吸道感染(22.7%,25/110);诊断为毛细支气管炎的占10.9%(12/110),其中诊断支气管炎占7.3%(8/110)。2004年7月至2005年6月期间几乎每个月份(除2005年5月和6月)都检出hMPV感染的阳性标本,未出现明显的流行高峰。而2005年7月至2006年6月期间hMPV出现了较为明显的流行,于2006年4月为最高峰,阳性检出率为17.1%。110例hMPV感染的临床标本中有6份标本存在与其他呼吸道病毒的合并感染。hMPV和同期的人呼吸道合胞病毒的感染高峰没有重叠。结论hMPV是北京地区婴幼儿急性呼吸道感染(尤其是下呼吸道感染)的重要病毒病原之一,其感染对2岁以下婴幼儿威胁更大。
Objective To understand the infection of human metapneumovirus (hMPV) in infants and young children with acute respiratory infection in Beijing. Methods A total of 3330 clinical samples of throat swab and nasopharyngeal wash from children hospital outpatient and inpatient respiratory infection affiliated to Capital Institute of Pediatrics from July 2004 to June 2006 were collected for cell culture and indirect immunofluorescence assay for viruses. Simultaneously The virus RNA was extracted from the sample and amplified by RT-PCR. The fragment was located on the hMPV M gene. The amplified fragment was detected by agarose gel electrophoresis. Results A total of 110 hMPV positive specimens were detected from 3330 clinical specimens and the positive rate was 3.3%. The proportion of children with and without hMPV infection was 1.5: 1, with 46.4% (51/110) in children <1 year of age, 11.8% (13/110) in children of 1 year old, 2 to 5 years of age Children in the group accounted for 33.6% (37/110), and children in the> 5 year age group accounted for 8.2% (9/110). The prevalence of pneumonia in children with hMPV infection was the highest, accounting for 44.5% (49/110), followed by upper respiratory infections (22.7%, 25/110), bronchiolitis (10.9%, 12 / 110), of which bronchitis diagnosed accounted for 7.3% (8/110). Positive samples of hMPV infection were detected in almost every month (except May and June 2005) between July 2004 and June 2005, with no apparent epidemic peak. From July 2005 to June 2006 hMPV appeared more obvious epidemic, in April 2006 the highest peak, the positive detection rate was 17.1%. Six of the 110 hMPV-infected clinical specimens were co-infected with other respiratory viruses. There was no overlap in the peak of infection with hMPV and concurrent human respiratory syncytial virus. Conclusion hMPV is one of the most important viral pathogens in acute respiratory infections (especially lower respiratory tract infections) in infants and young children in Beijing. The infection is more threatening to infants under 2 years of age.