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为了解我国人副流感病毒（Human parainfluenza viruses, HPIVs）的流行特征和疾病负担，本研究对筛选出的2006至2025年我国155篇HPIVs感染相关中英文研究（覆盖25个省份944983名免疫功能正常个体）进行了系统回顾和Meta分析，以评估HPIVs感染的流行病学特征，并基于傅里叶项线性时间序列回归模型预测HPIVs流行趋势，采用归因分数估算5岁以下儿童HPIVs感染的疾病负担。结果显示，我国急性呼吸道感染（Acute respiratory infection, ARI）中HPIVs感染合并阳性率为7.25%(95%CI:6.26%～8.23%),5岁以下儿童为主要易感人群（6.42%,95%CI:5.63%～7.26%），其中<1岁婴幼儿合并阳性率最高（8.38%,95%CI:6.79%～9.97%）;2019年5岁以下儿童中约5.22%(18.6万例)的下呼吸道感染（Lower respiratory tract infection, LRTI）病例和5.23%(678例)LRTI相关死亡病例可归因于HPIVs感染。HPIV3和HPIV2主要感染1岁以下婴儿，而HPIV1和HPIV4则主要分布于1-2岁幼儿组；HPIVs与LRTI显著相关（合并阳性率为7.52%,95%CI:6.09%～9.25%），其中HPIV3、HPIV1和HPIV2在LRTI/严重急性呼吸道感染病例组的合并阳性率显著高于上呼吸道感染/轻型ARI病例组（均P<0.001）。北方地区合并阳性率（7.99%,95%CI:5.79%～10.19%），显著高于南方地区（6.79%,95%CI:5.69%～7.90%）(P<0.001)；除外HPIV4，各血清型在北方地区的合并阳性率均显著较高（P<0.001）;HPIVs流行呈现"夏季高发、秋冬季低发"特征，以HPIV3（流行高峰4～9月）和HPIV1（流行高峰6～10月）为主要流行型别。季节性流行模式在新冠疫情期间被打破，尽管2023-2024年疫情后已逐步恢复，但HPIVs感染合并阳性率（3.47%,95%CI:2.42%～4.70%）仍显著低于2019年之前的水平（5.55%,95%CI:4.82%～6.32%）。本研究完善了我国HPIVs流行病学数据，为指导临床诊疗、疾病防控和疫苗研发提供了重要循证依据。
Abstract：To characterize the epidemiological features and disease burden of human parainfluenza viruses(HPIVs) in China, we conducted a systematic review and meta-analysis of 155 Chinese and English studies published between 2006 and 2025, encompassing 944983 immunocompetent individuals from 25 provinces. The epidemiological patterns of HPIV infections were assessed, temporal trends were predicted using Fourier-term linear time-series regression models, and the disease burden among children under five years of age was estimated based on attributable fractions. The pooled positivity rate of HPIVs among acute respiratory infection(ARI) cases was 7.25%(95% CI: 6.26%–8.23%), with children under five years being the most susceptible population(6.42%, 95% CI: 5.63% – 7.26%). Infants younger than one year exhibited the highest positivity rate(8.38%, 95% CI: 6.79%–9.97%). In 2019, approximately 5.22%(186000 cases) of lower respiratory tract infections(LRTIs) and 5.23%(678 deaths) of LRTI-related fatalities among children under five were attributable to HPIV infection. HPIV3 and HPIV2 primarily affected infants under one year, whereas HPIV1 and HPIV4 were more prevalent among children aged 1– 2 years. HPIV infection was significantly associated with LRTIs(pooled positivity rate: 7.52%, 95% CI: 6.09% – 9.25%), and the positivity rates of HPIV3, HPIV1, and HPIV2 were significantly higher in LRTI/severe acute respiratory infection(SARI) cases than in upper respiratory tract infection(URTI) or mild ARI cases(all P < 0.001). Regionally, the pooled positivity rate in northern China(7.99%, 95% CI: 5.79%–10.19%) was significantly higher than that in southern China(6.79%, 95% CI: 5.69% – 7.90%)(P < 0.001), with all serotypes except HPIV4 showing higher prevalence in the north(P < 0.001). HPIVs displayed a distinct seasonal pattern characterized by summer peaks and autumn/winter troughs, with HPIV3(April – September) and HPIV1(June – October) being the predominant circulating serotypes. This seasonal pattern was disrupted during the COVID-19 pandemic, and although it gradually recovered during 2023 – 2024, the pooled positivity rate(3.47%, 95% CI: 2.42% –4.70%) remained significantly lower than pre-2019 levels(5.55%, 95% CI: 4.82% – 6.32%). This metaanalysis refines the epidemiological profile of HPIVs in China and provides robust evidence to inform clinical management, disease surveillance, and vaccine development strategies.
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基本信息:
DOI：10.13242/j.cnki.bingduxuebao.250312
中图分类号:R181.3;R511
引用信息:
[1]朱春羽,丁昊,何维燕,等.我国人副流感病毒相关急性呼吸道感染流行特征和疾病负担的Meta分析[J].病毒学报,2025,41(06):1775-1787.DOI:10.13242/j.cnki.bingduxuebao.250312.
基金信息:
北京市自然科学基金（项目号：L252067）,题目：基于多源数据的全球手足口病流行特征与亚太地区传播预测模型研究~~