济宁地区3~5岁就诊腹泻患儿轮状病毒感染流行特征及危险因素  

Epidemiological characteristics and risk factors of rotavirus infection in children aged 3-5 years who seek treatment for diarrhea in Jining area

作　　者：黄宗宣[1] 刘海霞[1] 盛芬[2] 肖兴娟 黄迎迎 Huang Zongxuan;Liu Haixia;Sheng Fen;Xiao Xingjuan;Huang Yingying(Department of Pediatrics,Affiliated Hospital of Jining Medical University,Jining 272029,China;Intensive Care Department,Jining First People′s Hospital,Jining 272002,China;Women′s Health Department of Rencheng District Maternal and Child Health Hospital,Jining 272005,China)

机构地区：[1]济宁医学院附属医院儿科,济宁272029 [2]济宁市第一人民医院重症医学科,济宁272002 [3]任城区妇幼保健院妇保科,济宁272005

出　　处：《中华实验和临床病毒学杂志》2024年第2期169-174,共6页Chinese Journal of Experimental and Clinical Virology

基　　金：山东省医药卫生科技发展计划(202006010928)。

摘　　要：目的分析济宁地区3~5岁就诊腹泻患儿轮状病毒感染流行特征及危险因素。方法收集2022年9月至2023年9月济宁地区医院698例3~5岁就诊腹泻患儿流行病学资料,同时采集粪便标本进行实验室检查,分析轮状病毒感染的流行特征,并采用Logistic回归分析腹泻患儿轮状病毒感染的危险因素,基于决策树建立腹泻患儿轮状病毒感染的预测模型,采用受试者工作特征(ROC)曲线验证模型的预测性能。结果济宁地区3~5岁就诊腹泻患儿轮状病毒抗原检测阳性302份,阳性率43.27%(302/698)。不同性别的轮状病毒感染阳性率比较差异无统计学意义(χ^(2)=1.862,P=0.172);轮状病毒感染阳性率随年龄增长呈降低趋势(χ^(2)=28.893,P<0.001);不同月份的轮状病毒感染阳性率比较差异有统计学意义(χ^(2)=241.607,P<0.001),呈明显季节性特点,高发月份为当年10月至次年3月,最高为12月份,最低为7月份。轮状病毒基因分型:G基因型分型结果显示以G9最常见,P基因型分型结果显示以P[8]最常见,G/P组合基因型分型结果显示以G9P[8]最常见。多因素Logistic回归分析结果显示:有吮指习惯(OR=4.193,P=0.018)、无接种轮状病毒疫苗(OR=1.947,P=0.002)、喂食前否清洁双手(OR=4.719,P=0.007)、轮状病毒感染患儿接触史(OR=4.976,P=0.001)是济宁地区3~5岁就诊腹泻患儿感染轮状病毒的独立危险因素。决策树模型灵敏度58.94%、特异度87.12%,AUC为0.814,说明筛选出的4个危险因素可较好的预测轮状病毒感染。结论济宁地区3~5岁就诊腹泻患儿轮状病毒感染阳性率较高,呈明显年龄、时间流行特征,基因型分布以G9、P[8]、G9P[8]为主,轮状病毒感染与有吮指习惯、无接种轮状病毒疫苗、喂食前否清洁双手、轮状病毒感染患儿接触史有关。Objective To analyze the epidemiological characteristics and risk factors of rotavirus infected in children aged 3-5 years seeking treatment for diarrhea in Jining area.Methods The epidemiological data of 698 children aged 3-5 years seeking treatment for diarrhea in Jining area hospitals from September 2022 to September 2023 were collected,and fecal samples were collected for laboratory examination.The epidemiological characteristics of the rotavirus infection were analyzed,and logistic regression analysis was applied to analyze the risk factors of rotavirus infection in children aged 3-5 years seeking treatment for diarrhea in Jining area.A predictive model of rotavirus infection in children aged 3-5 years seeking treatment for diarrhea in Jining area was established based on decision tree,and the predictive performance of the model was verified by receiver operating characteristic(ROC)curve.Results The detection of rotavirus antigen showed 302 positive cases,with a positive rate of 43.27%(302/698).Gender distribution:There was no statistically significant difference in the positive rate of rotavirus infection in these diseased children etween different genders(χ^(2)=1.862,P=0.172).Age distribution:The positive rate of rotavirus infection in these diseased children showed a decreasing trend with age(χ^(2)=28.893,P<0.001).Time distribution:There was a statistically significant difference in the positive rate of rotavirus infection in these diseased children among different months(χ^(2)=241.607,P<0.001),showing obvious seasonal characteristics,the high incidence months were from October to the following March,the highest positive rate was in December,and the lowest was in July.Rotavirus genotype:The G genotype result showed that G9 was the most common,P genotype result showed that P[8]was the most common,and the G/P combination genotype result showed that G9P[8]was the most common.Multivariate Logistic regression analysis showed that having finger sucking habits(OR=4.193,P=0.018),lack of vaccination against rot

关 键 词：腹泻 轮状病毒 流行特征 危险因素 

分 类 号：R725.1[医药卫生—儿科] R181.3[医药卫生—临床医学]