中国实用儿科杂志

中国实用儿科杂志

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小儿病毒性腹泻病原谱及临床特征分析

  

  1. 1 吉林省儿童医学中心（长春市儿童医院），吉林  长春  130061；2 吉林省疾病预防与控制中心，吉林  长春  130000
  • 出版日期:2019-07-06 发布日期:2019-07-12

Analysis of pathogenic spectrum and clinical characteristics of viral diarrhea in children

  1. *Changchun Children’s Hospital，Changchun  130061，China
  • Online:2019-07-06 Published:2019-07-12

摘要：

目的　探讨小儿病毒性腹泻病原谱及临床特点。方法　采集400例2016年1至12月吉林省儿童医学中心（长春市儿童医院）住院疑似病毒性腹泻患儿粪便标本，约5 mL，应用酶联免疫吸附试验（ELISA）检测轮状病毒抗原和聚合酶链反应（PCR）方法检测轮状病毒（HRV）、杯状病毒（HUCV）、肠道腺病毒（HADV）和人星状病毒（HAstaV）核酸及基因型，同时收集患儿临床资料。结果　粪便标本HRV、HuCV、EAdV和HAstV总阳性检出率为59%（236例）；4种病毒的阳性检出情况分别为178例（75.42%）、68例（28.81%）、12例（5.08%）和5例（2.12%），其中双重混合感染占27例（11.42%）；未知病原占164例（41%）。轮状病毒G6（93.63%，147例）、P3（91.08%）和G6［P3］（90.45%）组合为2016年流行优势型，未能分型11.79%。杯状病毒中92.65%为诺如病毒，其中98.41%为GⅡ型。住院病毒性腹泻193例年龄≤24月龄；发病高峰年龄段不同病原不同。发病高峰季为1～3月份和12月份。主要临床表现有腹泻、呕吐和发热等。结论　对于小儿病毒性腹泻，确定未知病原种类，完善病原谱非常必要。病毒性腹泻常伴发肠道外临床表现。

关键词: 小儿, 病毒性, 腹泻, 病原谱, 临床特征

Abstract:

To study the pathogenic spectrum and the clinical characteristics of viral diarrhea in children. Methods　The study was conducted in 400 children with viral diarrhea hospitalized in Children’s Hospital from January to December in 2016. The stool specimens（about 5 mL） were collected for detection from the children on the day of hospitalization. The ELISA method and PCR method were used to detect the genotypes of HUCV，HADV，HAstaV and HRV in stool specimens，and the clinical data of children were collected at the same time. Results　In 2016，the total positive rate of HRV，HUCV，EAdV and HAstV in the stool specimens of children with viral diarrhea was 59%（236 cases）. The positive detection rates of the four viruses were 178 cases（75.42%），68 cases（28.81%），12 cases（5.08%） and 5 cases（2.12%） respectively，of which 11.42% were double mixed infection and 41% were of unknown pathogens. The HRVG6（93.63%，147 cases） and P3（91.08%） as well as G6［P3］（90.45%） combination were the popular superior type in 2016，and about 11.79% couldn’t be typed. Norovirus accounted for 92.65% of the calicivirus viruses，and GⅡ accounted for 98.41%. About 81.79% of the children（193 cases） hospitalized for viral diarrhea were less than 24 months old. Pathogens were different at different peak age. The peak season of onset was from January to March and December. The main clinical manifestations were diarrhea，vomiting and fever. Conclusion　It is essential to determine the unknown pathogens and improve the pathogenic spectrum in children with viral diarrhea. Viral diarrhea is often accompanied by extraintestinal clinical manifestations.

Key words: child, viral, diarrhoea, pathogenic spectrum, clinical characteristics