2021年至2022年单中心急性胃肠炎患儿诺如病毒感染流行情况分析  

Analysis of the prevalence of norovirus infection in children with single center acute gastroenteritis during 2021-2022

作　　者：顾秀丽 张晓飞[1] 刘颖[1] 张伟[1] 王思雪 李启亮[1] Gu Xiuli;Zhang Xiaofei;Liu Ying;Zhang Wei;Wang Sixue;Li Qiliang(Department of Clinical Laboratory,Beijing Children′s Hospital,Capital Medical University,National Center for Children′s Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心、首都医科大学附属北京儿童医院检验中心,100045

出　　处：《国际儿科学杂志》2024年第3期193-197,共5页International Journal of Pediatrics

基　　金：高层次公共卫生技术人才建设项目(学科骨干-01-024)。

摘　　要：目的探讨2021年至2022年急性胃肠炎患儿的诺如病毒流行情况及诺如病毒感染与粪便性状、临床症状之间的相关性。方法收集2021年1月至2022年12月就诊于首都医科大学附属北京儿童医院的2195例急性胃肠炎患儿的肛拭子标本,采用PCR荧光探针法对诺如病毒进行检测,并对临床信息及检测数据进行统计学分析。结果2195例患儿诺如病毒总检出率为19.09%(419/2195),男、女患儿检出率分别为17.80%(244/1371)、21.24%(175/824),差异有统计学意义(χ^(2)=3.945,P<0.05)。诺如病毒在1月龄~3岁婴幼儿阳性率较高[29.09%(64/220)~40.69%(94/231)],其中1岁患儿阳性率最高[40.69%(94/231)]。不同月份诺如病毒的检出率在2.44%(2/82)~35.84%(62/173)之间,其中1~3月诺如病毒检出率较高。冬季和春季为诺如病毒高发季节,检出率分别为28.36%(150/529)、21.07%(146/693),呈明显的季节性分布。诺如病毒阳性的患儿中同时有呕吐和腹泻症状的概率明显高于阴性患儿,差异有统计学意义(χ^(2)=57.29,P<0.05)。结论在冬春高发季节,对于腹泻伴有呕吐症状的1月龄~3岁婴幼儿,特别是1岁患儿,建议及时进行诺如病毒相关检测。及早对确诊患儿进行相关治疗和隔离措施,对减少交叉感染及避免暴发流行尤为重要。Objective To investigate the prevalence of norovirus and the correlation between norovirus infection and stool traits and clinical symptoms in children with acute gastroenteritis during 2021-2022.Method A total of 2195 anal swab samples were collected from cases of acute gastroenteritis in Beijing Children's Hospital Affiliated to Capital Medical University from January 2021 to December 2022.PCR fluorescent probe assay was performed to detect norovirus,the clinical information and test results were performed by statistical analysis.Results The detection rate of norovirus was 19.09%(419/2195)in 2195 children.The detection rates of male and female were 17.80%(244/1371)and 21.24%(175/824),respectively,with statistically significant differences between genders(χ^(2)=3.945,P<0.05).The positivity rate of noroviruses was higher in aged 1 month to 3 years[29.09%(64/220)~40.69%(94/231)],especially in 1 year[40.69%(94/231)].The norovirus detection rate ranged from 2.44%(2/82)to 35.84%(62/173)in different months,with a high detection rate between January and March,higher in the winter and spring[28.36%(150/529),21.07%(146/693)],showing a clear seasonal distribution.Clinical symptoms of both vomiting and diarrhea were significantly more common among norovirus positive than negative children,the difference was statistically significant(χ^(2)=57.29,P<0.05).Conclusion In the high incidence season of winter and spring,for infants and young children aged 1 month to 3 years with diarrhea accompanied by vomiting symptoms,especially those aged 1 year,it is recommended to undergo norovirus related testing in time.Early treatment and isolation measures should be taken for diagnosed children to reduce cross infection and prevent outbreaks.

关 键 词：儿童 急性胃肠炎 诺如病毒 流行特征 

分 类 号：R725.7[医药卫生—儿科] R181.3[医药卫生—临床医学]