天津地区急性腹泻患儿肠道病毒感染临床特征和流行病学分析  被引量:4

Clinical characteristics and epidemiological of enterovirus infection in children with acute diarrhea in Tianjin

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作  者:武晋英 方玉莲[1] 王维[1] 侯梦珠 王露 赵煜[2] WU Jinying;FANG Yulian;WANG Wei;HOU Mengzhu;WANG Lu;ZHAO Yu(Tianjin Children's Hospital,Tianjin Institute of Pediatric Research,Tianjin Key Laboratory for Prevention and Treatment of Birth Defects,Tianjin 300134,China;Department of Gastroenterology,Tianjin Children's Hospital,Tianjin 300134,China)

机构地区:[1]天津市儿童医院天津市儿科研究所天津市儿童出生缺陷防治重点实验室,天津300134 [2]天津市儿童医院消化科,天津300134

出  处:《检验医学》2023年第3期267-271,共5页Laboratory Medicine

基  金:天津市卫生健康委员会科研项目(TJWJ2022QN083)。

摘  要:目的了解天津地区可引起儿童腹泻的常见肠道病毒的临床和流行病学特征,为指导儿童病毒性腹泻的防治提供参考。方法收集2019年8月—2020年7月天津市儿童医院1102例急性腹泻住院患儿临床资料和粪便样本,患儿男680例、女422例,年龄1~148个月。采用胶体金免疫层析技术检测轮状病毒和肠道腺病毒,采用逆转录聚合酶链反应(PCR)检测诺如病毒。分析病毒检测结果和临床资料信息。结果1102例粪便样本中,有421例(38.2%)检出病毒阳性,诺如病毒、轮状病毒、腺病毒的检出率分别为24.9%、11.0%、2.4%。诺如病毒和轮状病毒冬、春季检出率较高,腺病毒夏、秋季检出率较高。不同年龄患儿3种肠道病毒检出率差异有统计学意义(P<0.05),不同性别患儿诺如病毒和腺病毒检出率差异有统计学意义(P<0.05)。不同肠道病毒引起的发热、咳嗽、呕吐、腹痛等急性腹泻伴随症状发生率不同(P<0.05);腺病毒感染患儿水、电解质和酸碱平衡紊乱的发生率更高(P<0.05);轮状病毒感染患儿粪便常规脂肪滴检出率和外周血白细胞下降发生率更高(P<0.05)。结论诺如病毒和轮状病毒是天津地区儿童腹泻的主要病原,婴幼儿多发,且具有明显的季节性。患儿感染不同病毒引发的主要临床症状和实验室检验结果有差异,临床可根据不同病毒引发的腹泻特点有针对性地进行治疗。Objective To investigate the clinical characteristics and epidemiological of enterovirus in children with acute diarrhea in Tianjin,and to provide a reference for the prevention and treatment of viral diarrhea.Methods The 1102 stool samples of hospitalized children with acute diarrhea admitted in Tianjin Children's Hospital from August 2019 to July 2020 were collected,and there were 680 boys and 422 girls,aged 1-148 months.Rotavirus and adenovirus were determined by colloidal gold immunochromatography,and norovirus was determined by reverse transcription polymerase chain reaction(PCR).The determination results and clinical data were collected and analyzed.Results Totally,421(38.2%)children were positive for viruses,and the determination rates of norovirus,rotavirus and adenovirus were 24.9%,11.0%and 2.4%,respectively.Norovirus and rotavirus had high determination rates in winter and spring,while adenovirus had high determination rates in summer and autumn.There was statistical significance in the determination rates of the 3 enteroviruses in different age groups(P<0.05),and there was statistical significance in the determination rates of norovirus and adenovirus between boys and girls(P<0.05).The incidence rates of associated symptoms such as fever,cough,vomiting and abdominal pain of acute diarrhea caused by different enteroviruses were different(P<0.05).The incidence rates of water,electrolyte and acid-base disturbance were higher in adenovirus infected children(P<0.05).The incidence rate of fat droplets in stool routine examination and the incidence rate of leukopenia in peripheral blood were higher in rotavirus infected children(P<0.05).Conclusions Norovirus and rotavirus are the main etiological factors of diarrhea among children in Tianjin and mostly occur in infants and young children with obvious seasonality.The clinical characteristics and laboratory examination results of diarrhea caused by different viral infections are different,which may provide a reference for the clinical treatment of diarrhea.

关 键 词:肠道病毒 急性腹泻 流行病学 临床特征 儿童 天津市 

分 类 号:R373.2[医药卫生—病原生物学]

 

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