儿童急性病毒性腹泻病原流行趋势分析  

Analysis of pathogenic prevalence in children with acute viral diarrhea

作　　者：邓莉[1] 黄辉[1] 金凤华[1] 郑崇光[1] 董慧瑾[2] 贾立平[2] 刘立颖[2] 钱渊[2] 

机构地区：[1]首都儿科研究所附属儿童医院感染科,100020 [2]首都儿科研究所病毒室

出　　处：《北京医学》2015年第6期521-523,共3页Beijing Medical Journal

摘　　要：目的探讨儿童急性病毒性腹泻的病原流行趋势。方法对2013年3月至2014年12月在首都儿科研究所附属儿童医院感染科门诊就诊的急性腹泻患儿的粪便标本进行病毒学检测(包括轮状病毒、诺如病毒、肠腺病毒),新鲜粪便标本冷藏保存,使用Trizol和DNAzol试剂提取粪便标本核酸(RNA和DNA),分别用聚丙烯酰胺凝胶电泳(PAGE)检测粪便标本中的轮状病毒,RT-PCR方法检测诺如病毒核酸,PCR方法检测肠腺病毒DNA。结果留取粪便标本共1 295份,病原学阳性411份(阳性率31.7%)。其中轮状病毒单一阳性282份,占阳性标本的68.6%;诺如病毒单一阳性78份,占阳性标本的19.0%;肠腺病毒单一阳性25份,占阳性标本的6.1%;2种病毒混合感染26例,占阳性标本的6.3%。不同病毒检出率呈明显季节变化,轮状病毒检出率高峰在11月份,诺如病毒检出率高峰在10月份,肠腺病毒检出率高峰在6月份,检出率分别为67.9%、18.7%、5.4%。混合感染以轮状病毒和诺如病毒感染为主。结论轮状病毒是儿童急性病毒性腹泻的主要病原,诺如病毒成为儿童急性病毒性腹泻的第2大病原。秋冬季节为轮状病毒腹泻的高发期,诺如病毒流行季节较轮状病毒略早,肠腺病毒流行主要发生在夏季。混合感染以轮状病毒合并诺如病毒感染多见,且好发于轮状病毒流行季节。3种病毒引起的腹泻在非流行季节均有散发病例。Objective To investigate the epidemiology characteristic of pathogeny in children with acute diarrhea. Methods The pediatric patients who were diagnosed with acute viral diarrhea from March 2013 to December 2014 were enrolled in the study. Fresh stool specimens of children with acute diarrhea were freezed to unified test pathogens. RNA and DNA of the stool specimens was extracted by Trizol and DNAzol reagent, then rotavirus was detected by PAGE, noro-virus was detected by RT-PCR and enteric adenovirus was detected by PCR respectively. Results Among 411 cases identified pathogen, 282 were infected by rotavirus, 78 by norovirus, 25 by enteric adenovirus and 26 by mixed virus. Three kinds of viruses were distributed throughout the year. However there were obvious seasonal differences in different viruse, rotavirus, norovirus, enteric adenovirus had the highest detection rate respectively in November, October and June, the each detection rate was 67.9%, 18.7% and 5.4%. Conclusion Rotavirus is the main pathogens of acute viral enteritis in children, and norovirus becomes the second. Rotavirus epidemic occurs mainly in the autumn and winter, norovirus epidemic occurs slightly earlier, and enteric adenovirus epidemic occurs in the summer. There is a high incidence of mixed infection with rotavirus and norovirus in rotavirus epidemic season. The sporadic cases of the 3 kinds of viral diarrhea are distributed throughout the year.

关 键 词：病毒性腹泻 轮状病毒 诺如病毒 肠腺病毒 

分 类 号：R725.1[医药卫生—儿科]