轮状病毒感染患儿的临床特征及相关因素分析  

Clinical characteristics and related factors of rotavirus infections

作　　者：马德强[1] 王道静 王梅春[2] 

机构地区：[1]烟台市烟台山医院儿科,山东烟台264000 [2]烟台市烟台山医院检验科,山东烟台264000

出　　处：《中华医院感染学杂志》2017年第17期4016-4019,共4页Chinese Journal of Nosocomiology

摘　　要：目的分析轮状病毒感染患儿的临床特征及相关因素,为临床诊疗提供指导依据。方法选取2015年1月-2016年12月来医院就诊的200例腹泻患儿,采用免疫层析胶体金法进行轮状病毒检测,观察轮状病毒的感染情况,流行发病时间、患儿易感年龄、临床特征及血清白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、肿瘤坏死因子(TNF)、干扰素(INF-α)情况;同时搜集患儿的病例资料,单因素统计分析发生轮状病毒感染的相关因素,进一步行多因素回归分析引发感染的高危因素。结果 200例急性腹泻患儿共检出51例轮状病毒,检出率为25.5%;各月龄组患儿的轮状病毒检出率比较,差异有统计学意义(P<0.05),其中以6~12月龄患儿的轮状病毒检出率较高;患儿的轮状病毒感染在各季节的检出率比较,差异有统计学意义(P<0.05),其中以秋、冬季节检出率较高,分别为39.5%和46.3%;轮状病毒感染患儿在不同性状样便的阳性检出率比较,差异有统计学意义(P<0.05),其中在蛋花汤样腹泻患儿的阳性检出率最高,达47.9%;轮状病毒感染患儿的血清IL-2、IL-6、TNF、INF-α表达水平均显著高于非感染组患儿,差异均有统计学意义(P<0.05);单因素分析结果显示,母乳喂养、患儿挑食、患儿手卫生、住院时间>15d、侵入性检查、抗菌药物连续应用>1周及应用肠道微生态制剂与患儿发生轮状病毒感染具有相关性(P<0.05);非条件logistic多元素回归分析结果显示,采用母乳喂养、住院时间>15d、抗菌药物连续应用>1周、应用肠道微生态制剂是轮状病毒感染的独立危险因素。结论轮状病毒在急性腹泻患儿粪便中检出率较高,月龄在6~12个月、秋冬季节、大便性状为蛋花汤样检出率最高;母乳喂养、住院时间>15d、抗菌药物连续应用>1周及应用肠道微生态制剂与轮状病毒感染密切相关。OBJECTIVE To analyze the clinical characteristics and related factors of rotavirus infections,so as to provide guidance for clinical diagnosis and treatment.METHODS A total of 200 cases of diarrhea patients from Jan.2015 to Dec.2016 in our hospital were selected.Rotavirus were detected using colloidal gold immunochromatography,and rotavirus infections,epidemic onset,children susceptible age,clinical features and serum IL-2,IL-6,TNF and INF-α were observed.At the same time,the case data of children were collected,the related factors of rotavirus infections were analyzed by univariate analysis,and the risk factors of infections were analyzed by multivariate regression analysis.RESULTS Totally 51 cases of rotavirus were detected in children with acute diarrhea,and detection rate was 25.5%.There was a significant difference in the detection rate of rotavirus among children of different age groups（P〈0.05）,and the detection rate of rotavirus was higher in children of 6～12 months.The detection rate of rotavirus infections in children in different seasons had significant differences（P〈0.05）,which were higher in autumn and winter,respectively 8.5%and 9.5%.The positive detection rate of rotavirus infections in children with different traits was also significant（P〈0.05）,among which the positive rate was the highest of 47.9%in children with egg soup diarrhea.The serum levels of IL-2,IL-6,TNF and INF-α in children with rotavirus infections were significantly higher than those in non infected group（P〈0.05）.Univariate analysis results showed that breastfeeding,picky eaters,hand hygiene,hospital stay more than 15 days,invasive examination,continuous application of antibiotics more than 1 week and application of intestinal probiotics were correlated with rotavirus infections in children（P〈0.05）.Unconditional logistic multivariable regression analysis results showed that： breastfeeding,hospital stay more than 15 days,continuous application of antibiotics more than 1 week and application of intes

关 键 词：轮状病毒 感染 临床特征 相关因素 

分 类 号：R373.2[医药卫生—病原生物学]