| Objectives This study is designed to clarify the epidemiological characteristics of respiratory viral infections in children in Wuxi.we investigate the clinical characteristics and the expression level of common inflammation-related factors in children infected with respiratory syncytial virus(RSV)and Influenza virus type A(Inf-A),and understand what it means for clinical work.Methods1.Epidemiological Study on Seven Common Respiratory Viruses in Wuxi: From January 2010 to December 2016,a total of 2160 cases aged 0-14 years old who are treatment for ARI in Wuxi Second People's Hospital,Wuxi Ninth People's Hospital,Dongting Community Hospital in Wuxi,and Yingshanhe Women's Hospital in Wuxi are enrolled in the present study.we collect the respiratory tract specimens,and RSV,adenovirus(ADV),influenza virus type A and B(Inf-A and Inf-B)and para Influenza virus type 1 ~ 3(PIV1 ~ 3)were detected with the D3 Ultra DFA Respiratory Virus Identification Kit(D3 DFA Kit).In addition,Demographic data,clinical symptoms and laboratory results etc are collected.By analyzing the correlation among age,seasons,diseases and seven respiratory viral infections,the study describes the epidemic characteristics of various respiratory viruses in Wuxi.2.Due to the highest incidence of RSV infection and mixed infection in this region,we analyzed the clinical features of children infected with RSV and Inf-A virus.: From January 2010 to December 2016,20 patients aged less than 5 years old and infected with RSV and Inf-A(MIX group)who were admitted to the Second People's Hospital of Wuxi City for acute respiratory infection were retrospectively analyzed.At the same time,30 RSV-infected children(RSV group)were selected as the control group.We make analysis in this two groups.3.Study on level of serum inflammatory factors in children infected with RSV and FA virus: 95 subjects are included in this study,who are divided into four groups: the FA goup(FA tested positive only),the RSV group(RSV tested positive only),the mixed infection group(both FA and RSV tested positive)and age-matched healthy controls.Bio-Plex suspension chip technique or enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of seven common inflammatory factors in four groups.It mainly includes Interferon-?(IFN-?),Interleukin-2(IL-2),IL-4,IL-8,IL-1?,Transforming growth factor-?(TGF-?),TNF-a;We also analyzed the correlation between the levels of inflammatory factors and the severity of the disease in the four groups.Results1.This study enrolled 2160 patients who were infected with ARI from January 2010 to December 2016.There were 760 cases whose virus detection were positive,and the positive detection rate was 35.19%.The RSV positive detection rate was highest,followed by FA,FB,ADV,PIV1,PIV2,and PIV3.There were 42 cases of mixed infection,accounting for 5.52%.RSV was most common in mixed infections.The highest detection rate of viral respiratory pathogen was in group aged 0~1 years old,followed by group aged 3~14 years old and group aged 1~3 years old.The detection rate of RSV was the highest in group aged 0~1 year old,and the detection rate of FB was the highest in group aged 3~14 year old.Among the 85 neonates,25 were positive for virus detection,with a positive rate of 30.59%,mainly by RSV.In terms of seasonal distribution,respiratory viral infections mainly occurred in winter,and the RSV detection rates were highest in the winter,spring,and autumn seasons(a total of 368 samples were positive),and the detection rate of Inf-B was highest in summer.The RSV detection rate was highest in children with wheezing,accounting for 47.41% of patients with positive detection of virus.2.The mean age of MIX group was 21.71±0.84 months,which is higher than that of RSV group was 10.61±2.15 months.Compared with clinical characteristics,the incidence of fever,vomiting,and dyspnea in this two groups,the incidence of the MIX group was significantly higher than that in RSV group.The incidence of cough and nasal congestion was significantly higher in the RSV group than in the MIX group.There was no significant difference in the incidence of wheezing and pulmonary rales between the two groups;In term of clinical diagnosis,20% of MIX patients had severe pneumonia,which was higher than RSV(6.67%)(P=0.026);in term of peripheral blood routine WBC(Leukocyte,WBC)count,neutrophil percentage,platelet count,MIX group and RSV group were not statistically different.The proportion of CRP(C-Reactive protein,CRP)increased similarly in both groups,but the proportion of children with CRP>40 mg was higher in MIX group than in RSV group;the incidence of myocardial damage in MIX group was higher than that in RSV group,but in both groups,there was no significant difference in heart failure,respiratory failure,and liver function impairment in children.In term of treatment,patients accepted with intravenous use of glucocorticoids in the MIX group had an longer hospital stay than the RSV group.There was no statistical difference between respiratory support,oxygen inhalation,inhaled corticosteroids,and inhaled bronchodilators.3.A total of 95 patients were included in this study.The results showed that expression level of IL-1?,IL-8,TNF-?,and IFN-? increased in various degree in three infected groups.IL-2 didn't increase in the RSV group and was not significantly elevated in the mixed infection group.The expression of IL-1??TNF-? and IL-8 in the mixed infection group were significantly higher.In the recovery period of the disease,IL-1?,TNF-?,IL-8,and IFN-? all decreased significantly,but the levels of TNF-? and IFN-? were still significantly higher than those of the healthy control group.Expression of IL-4 and TGF-?were not significantly elevated in the RSV group,the FA group and the mixed infection group,and there was no statistical significance between the infected group and the healthy control group.Conclusions1.From 2010 to 2016,the epidemic of seven respiratory viruses in Wuxi showed a steady trend overall;In January 2013,there may be a small epidemic of RSV infection;RSV was the main pathogen causing acute respiratory infections in winter in children aged 0-1 years old in Wuxi,which clinically manifests as wheezing disease.2.Infection mixed with RSV and Inf-A is prone to occur in older children,which is more prone to manifests as fever,vomiting,diarrhea,dyspnea and other symptoms,especially fever,severe pneumonia.RSV Infection mixed with Inf-A can aggravate the condition.The proinflammatory cytokines increased predominantly in children infected with FA and RSV,IL-1?and TNF-? accounts mainly. |
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