小儿散发诺如病毒感染特征临床分析  

Clinical analysis of characteristics of sporadic norovirus infection in children

作　　者：汪洋[1] 张未 WANG Yang;ZHANG Wei(不详;Department of Gastroenterology,Maternal and Child Health Hospital of Hubei Province,Wuhan,Hubei 430070,China)

机构地区：[1]华中科技大学同济医学院附属湖北省妇幼保健院湖北省妇女儿童医院消化内科,湖北武汉430070 [2]华中科技大学同济医学院附属湖北省妇幼保健院湖北省妇女儿童医院呼吸内科,湖北武汉430070

出　　处：《中国临床研究》2022年第8期1106-1110,共5页Chinese Journal of Clinical Research

摘　　要：目的通过对小儿散发诺如病例感染病例的症状表现、实验室检查、影像学检查等临床资料进行分析,了解其临床特征。方法对2019年1月1日至2021年1月1日在湖北省妇幼保健院住院,诺如病毒RNA检测阳性的81例住院患儿的临床资料进性回顾性分析。结果81例散发诺如病毒感染病例中,男41例,女40例,发病年龄均<5岁,1~3岁最高为52例(64.2%)。诺如病毒感染具有明显的季节性,武汉地区在1月及12月感染率最高。主要临床表现包括呕吐81例(100%),腹泻72例(88.9%),发热53例(65.4%),无热惊厥15例(18.5%)。以呕吐为单一首发症状的60例(74.1%)患儿,外周血白细胞明显增高,为(14.5~39.0)×10^(9)/L。诺如病毒感染引起的无热惊厥患儿脑脊液常规及生化检查未见明显异常,急性期脑电图未见异常放电;头颅MRI未见异常信号。结论散发小儿诺如病毒感染冬春季节发病率高,发病人群以5岁以下为主。呕吐及腹泻、发热是小儿诺如病毒感染最常见的症状并伴随水电解质紊乱,且一般以呕吐为首发症状;体温>39℃以上较为少见,且发热持续时间不长。呕吐后出现无热惊厥是诺如病毒感染的另一个重要症状;以呕吐为首发症状患儿血常规白细胞多数明显增高,中性粒细胞为主。Objective To understand the clinical characteristics of sporadic norovirus cases in children by analyzing the clinical data such as symptoms,laboratory examination and imaging examination.Methods The clinical data of 81 hospitalized children with norovirus RNA positive in Hubei Maternal and Child Health Hospital from January 1,2019 to January 1,2021 were analyzed retrospectively.Results Among 81 cases of sporadic norovirus infection,there were 41 males and 40 females.The age of onset was less than 5 years old,and the highest age was 52 cases(64.2%)from 1 to 3 years old.Norovirus infection had obvious seasonality,and the infection rate in Wuhan was the highest in January and December.The main clinical manifestations included vomiting[100%(81/81)],diarrhea[88.9%(72/81)],fever[65.4%(53/81)]and febrile convulsion[18.5%(15/81)].In 60 children(74.1%)with vomiting as the single first symptom,the peripheral blood leukocytes increased significantly(14.5-39.0)×10^(9)/L.The routine and biochemical examination of cerebrospinal fluid in children without febrile convulsion caused by norovirus infection showed no obvious abnormality,and no abnormal EEG discharge was found in acute phase,as well as no abnormal signal was found in cranial MRI.Conclusions The incidence rate of sporadic norovirus infection in children is high in winter and spring,and the majority of patients are under 5 years old.Vomiting,diarrhea and fever are the most common symptoms of norovirus infection in children,accompanied by fluid and electrolyte disturbances,and vomiting is generally the first symptom;body temperature above 39℃is rare,and the duration of fever is not long.Febrile convulsion after vomiting is another important symptom of norovirus infection;with vomiting as the first symptom,most of the blood routine leukocytes in children were significantly increased,mainly neutrophils.

关 键 词：诺如病毒 小儿 临床特点 发热 呕吐 无热惊厥 腹泻 

分 类 号：R725.1[医药卫生—儿科]