2006-2015年成都地区5岁以下病毒性腹泻住院患儿病原学特征分析  

Etiologic characteristics of viral gastroenteritis in hospitalized children under 5 years of age in Chengdu area from 2006 to 2015

作　　者：谢晓丽 熊励晶 商丽红 刘丽荣 任敏[2] 何树森[2] Xie Xiaoli Xiong Lijing Shang Lihong Liu Lirong Ren Min He Shusen(Department of Pediatric Gastroenterology, Chengdu Women ＆ Children＇s Central Hospital, Chengdu 610091, China （ Xie XL, Xiong L J, Shang LH, Liu LR Institute of Microbiology, Sichuan Provincial Center for Disease Control and Prevention, Chengdu 610041, China（ Ren M,He SS)

机构地区：[1]成都市妇女儿童中心医院儿童消化科,610091 [2]四川省疾病预防控制中心微生物检验所,成都610041

出　　处：《中华实验和临床病毒学杂志》2017年第4期325-328,共4页Chinese Journal of Experimental and Clinical Virology

基　　金：云南及周边省市传染病病原谱流行规律研究（2009ZX10004-212）;四川省卫计委课题（070339）;成都市卫计委课题（2015136）

摘　　要：目的 对成都地区5岁以下急性腹泻病患儿进行病毒学监测,了解引起腹泻常见病毒的流行特征,为指导病毒性腹泻的防控提供科学依据.方法 采集成都市妇女儿童中心医院儿童消化科2006年3月至2015年6月5岁以下腹泻住院患儿粪便标本,并送四川省疾病预防控制中心进行病毒RNA提取与检测,并记录患儿临床资料.采用ELISA、RT-PCR方法对轮状病毒抗原进行检测与分型;采用RT-PCR方法对杯状病毒、星状病毒、腺病毒进行检测与分型.结果 共收集1-59月龄腹泻住院患儿粪便标本份共2 331份（男1 446份,女885份）,阳性检出率58.0％,以7-12月龄为好发年龄.轮状病毒阳性检出率28.3％,11 -12月份为流行季节.杯状病毒阳性检出率23.3％,9月份为流行季节,诺如病毒GII为主要感染株,未发现暴发流行.星状病毒阳性检出率1.5％,主要于1-3月份检出.腺病毒阳性检出率5.1％,主要于5-8月份检出,2011年有过小流行.2007年以后,轮状病毒的检出率较前明显下降,而同时杯状病毒检出率逐年升高,2010-2015年杯状病毒成为引起5岁以下患儿腹泻的主要病毒之一.绝大多数病毒性腹泻患儿为急性病程（91.2％）,以轻度脱水为主,其次为中度脱水,无重度脱水.可伴消化道外表现,轮状病毒的消化道外表现较杯状病毒多见,但在随访中均恢复正常.结论 病毒性腹泻是5岁以下儿童急性腹泻病常见原因,成都地区以轮状病毒、杯状病毒为主要病原体.Objective To identify the epidemiological characteristics of the common diarrhearelated virusesof children under 5 years of age in Chengdu area,and provide the objective evidences for prevention and control of diarrhea.Methods Fecal specimens collected from children with acute gastroenteritis between March 2006 and June 2015 were sent to Center for Disease Control and Prevention （CDC） of Sichuan province for detection of viral RNA.Clinical data were also documented.Enzyme-linked immunosorbent assay（ELISA） and/or Reverse transcriptase-polymerase chain reaction（RT-PCR） were used to detect and classify rotavirus,human calicivirus,adenovirus and astrovirus.Results A total of 2 331 fecal specimens from children （1 446 male and 885 female） under 5 were collected.1 351 were identified as having viral gastroenteritis with the overall positive rate of 58.0%.Children at the age from 7 to 12 months were the susceptible population.Rotavirus was detected in 659 specimens （28.3%） with epidemic time from November to December.Human calicivirus was detected in 542 specimens （23.3%） and September was its epidemic time.Norovirus GII was the main strain of the virus,but no outbreak was observed in our study.Prevalence of rotavirus declined after 2007,while the detection rate of calicivirus was increasing,which led it to be one of the primary pathogens related to viral gastroenteritis in children under 5.Astrovirus was detected in only 35 patients （1.5%） mainly identified from January to March.Adenovirus was detected in 118 patients （5.1%） mainly from May to August with limited epidemic in 2011.Most patients had acute progress（91.2%）,none have chronic progress.Mild dehydration was the most common symptom among all the children,followed by moderate dehydration,while none of the patient had severe symptom.Digestive symptoms are usually accompanied by extra-intestinal symptoms in both virus infection.However,extraintestinal symptoms had higher incidences in rotavirus infection than in calicivirus infe

关 键 词：病毒性腹泻 流行病学 儿童 

分 类 号：R725.7[医药卫生—儿科]