重症ＲＳウイルス患者における危険因子および分子遺伝子型研究

为了研究RSV-A ON 1的临床相关性，研究了2010年1月至2012年12月在越南中部庆和总医院纳入我们基于人群的前瞻性儿科ARI监测的急性呼吸道感染（ARI）病例。收集临床流行病学资料和鼻咽部样本。应用多重PCR方法对13种呼吸道病毒进行了筛查。通过对G-糖蛋白第二高变区进行测序，进一步检测RSV阳性样本的亚组（A/B）和基因型信息。统计分析RSV-A ON 1的临床流行病学特征。该研究证实了RSV-A ON 1感染ARI病例的临床相关性。在66.2%的病例中检测到呼吸道病毒，其中RSV（n = 426，23.0%）、流感病毒（12.0%）和鼻病毒（25.1%）是检测到的主要呼吸道病毒。RSV阳性者年龄明显较轻，喘息（52.8%）、呼吸急促（31.0%）、爆裂音（21.6%）和胸壁内陷（9.9%）明显较多见。在这项研究中，123 RSV-A ON 1和138 NA 1基因型。ON 1组患者年龄较轻，常伴有基础疾病和呼吸系统症状，如喘息（81.3%）、呼吸急促（50.4%）和呼吸困难（18.7%）。此外，在ON 1 ARI病例中，伴有LRTI（34.2%）和放射学证实的肺炎（19.5%）的ARI病例更常见。

To investigate the clinical relevance of RSV-A ON1,acute respiratory infection (ARI) cases enrolled to our population-based prospective pediatric ARI surveillance at Khanh Hoa General Hospital, Central Vietnam from January 2010 through December 2012 were studied. Clinical-epidemiological information and nasopharyngeal samples were collected. Multiplex PCR assays were performed for screening 13 respiratory viruses. RSVpositive samples were further tested for subgroups (A/B) and genotypes information by sequencing the G-glycoprotein 2nd hypervariable region. Statistical analysis was performed to evaluate the clinicalepidemiological characteristics of RSV-A ON1. The study demonstrated the clinical relevance of RSV-A ON1 infected ARI cases. Respiratory viruses were detected in 66.2% of the cases, in which RSV (n = 426, 23.0%), Influenza (12.0%) and Rhinovirus (25.1%) were the leading respiratory viruses detected. RSV-positive cases were significantly younger, wheezing (52.8%), tachypnea (31.0%), crackle (21.6%) and chest-wall indrawing (9.9%) were significantly more common. In this study, 123 RSV-A ON1 and 138 NA1 were genotyped. ON1 cases were younger, frequently associated with underlying medical condition and respiratory sign and symptoms such as wheeze (81.3%), tachypnea (50.4%) and difficulty in breathing (18.7%). In addition, ARI cases with LRTI (34.2%) and radiologically-confirmed pneumonia (19.5%) were more commonly seen in ON1 ARI cases.