婴幼儿病毒感染与腹泻相关临床参数的关系分析  

Analysis of relationship between viral infection and diarrhea-related clinical parameters in infants

作　　者：施前锋 潘新娣 王叶萍 邵伟芳 钱娇赟 孙爱华[2] 

机构地区：[1]浙江省长兴县人民医院检验科,浙江长兴县313100 [2]浙江医学高等专科学校微生物教研室,浙江杭州310053

出　　处：《中华医院感染学杂志》2015年第18期4252-4254,4267,共4页Chinese Journal of Nosocomiology

基　　金：浙江省自然科学基金资助项目(LY12H19002);浙江省湖州市科技计划基金资助项目(2011YS37)

摘　　要：目的研究婴幼儿病毒感染与腹泻相关临床参数的关系,为婴幼儿病毒性腹泻的诊治和预防提供依据。方法收集124例5岁以下腹泻患儿血液和粪便进行常规检测,采用免疫金层析技术检测粪便标本的轮状病毒,实时荧光定量PCR(RT-PCR)检测粪便标本轮状病毒、星状病毒、腺病毒及诺如病毒的表达水平,对结果采用SPSS16.0软件进行统计分析。结果 124例腹泻患儿中免疫金层析技术和RT-PCR检测轮状病毒阳性率分别为37.9%和46.0%;RT-PCR检测星状病毒、腺病毒及诺如病毒感染率分别为41.10%、19.40%和15.32%;重叠感染91例,其中轮状病毒与星状病毒重叠感染28例最为常见;急性胃肠炎患儿病毒感染率明显高于胃肠功能紊乱患儿(P<0.05);病毒感染在1岁以下腹泻患儿更常见(P<0.05),病毒感染腹泻患儿粪便性状常见水样;胃肠功能紊乱患儿血液C-反应蛋白(CRP)>10、白细胞(WBC)>10×109/L和粪便WBC阳性比例均明显高于急性胃肠炎患儿(P<0.05)。结论 RT-PCR可以提高腹泻患儿轮状病毒检出率,轮状病毒为腹泻患儿特别是<1岁患儿急性胃肠炎的主要病毒性因素,病毒性感染引起的腹泻以水样便更常见,胃肠功能紊乱患儿血像变化比急性胃肠炎患儿明显。OBJECTIVE To investigate the relationship between viral infection and diarrhea-related clinical parameters in infants so as to provide reference for diagnose and prevention of this disease.METHODS Blood and feces samples were collected for routine examination from 124 diarrhea children less than 5years of age.Test of rotavirus（RVs）in feces samples was carried out by immuno-gold chromatography and the expression levels of four virus（rotavirus,astrovirus,adenovirus,norovirus）in the feces samples were detected by RT-PCR.The results were statistically analyzed with the software SPSS16.0.RESULTS In the 124 children,the positive rates of RVs by immuno-gold chromatography and RT-PCR were 37.9% and 46.0%,respectively.The infection rates of astrovirus（ASTs）,human adenovirus（HADVs）and norovirus（NOVs）by RT-PCR were 41.10%,19.40% and 15.32%respectively.There were 91 cases of overlapping virus infection,among which the most common were 28 cases of overlapping infection caused by RVs and ASTs.The virus infection rate was significantly higher in patients with acute gastroenteritis than those with gastrointestinal dysfunction（P〈0.05）and virus infection was more common in diarrhea children under 1year of age（P〈0.05）.The feces from diarrhea children with virus infection were usually watery.The proportion of blood CRP〉10,WBC 〉10×10^9 and positive WBC in feces for children with gastrointestinal dysfunction was higher than that for children with acute gastroenteritis（P〈0.05）.CONCLUSION RT-PCR can improve the detection rate of RVs in diarrhea children.RVs are the primary viral factor for diarrhea children especially for those with acute gastroenteritis less than 1year of age and diarrhea caused by viral infection is the most manifested by watery stool.Blood index changes in children with gastrointestinal dysfunction are more significant than in those with acute gastroenteritis.

关 键 词：婴幼儿 腹泻 病毒 感染 

分 类 号：R722.132[医药卫生—儿科]