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目的与轮状病毒(RV)感染对比,了解诺如病毒(NV)感染的流行病学特点、临床特点及预后。方法 2012年11月至2013年10月,首都医科大学附属北京儿童医院选取3岁以下腹泻7 d以内婴幼儿的新鲜大便标本,筛选出无黏液、脓血的标本,应用胶体金免疫层析法检测NV及RV抗原。询问病史,依据Vesikari评分对腹泻严重程度进行评估,通过电话随访了解患儿预后。经统计分析,对NV及RV感染的流行病学特点、临床特点、预后进行对比研究。结果共入组942例,RV感染329例(34.9%),NV感染137例(14.5%),混合感染91例(9.7%)。RV感染存在明显的季节性,9月至次年2月为高发期;NV感染则全年散发。NV及RV感染在腹泻次数、腹泻持续时间、呕吐持续时间上均无统计学差异,但RV感染中,发热、呕吐、严重腹泻(伴有乏力、嗜睡、精神弱等症状)的比例明显高于NV感染(P<0.05),而流涕、咳嗽症状在NV感染更常见。NV感染Vesikari评分均值为(8.98±2.94)分,低于RV[(10.45±3.04)分,P<0.05)]。NV及RV感染多7 d以内好转,但NV感染易出现病程迁延。结论 RV仍为婴幼儿急性腹泻的主要病原,但NV感染检出率亦较高;NV感染呈全年散发,RV感染仍呈秋冬季节高发;RV感染出现发热、呕吐、严重腹泻较NV常见,而NV感染多伴呼吸道症状且病程易迁延。
Objective To compare the rotavirus (RV) infection and understand the epidemiological characteristics, clinical characteristics and prognosis of Norovirus (NV) infection. Methods From November 2012 to October 2013, fresh stool samples from infants younger than 3 years old with diarrhea under 3 years old were collected from Beijing Children’s Hospital Affiliated to Capital Medical University. Non-mucoid and septic blood samples were screened. Colloidal gold immunochromatography Detection of NV and RV antigens. Medical history was questioned, and the severity of diarrhea was evaluated according to Vesikari score. The prognosis was evaluated by telephone follow-up. After statistical analysis, the epidemiological characteristics, clinical characteristics and prognosis of NV and RV infection were compared. Results A total of 942 patients were enrolled in the study. RV infection was found in 329 cases (34.9%), NV infection in 137 cases (14.5%) and mixed infection in 91 cases (9.7%). There is a clear seasonal RV infection, from September to February next year for the high incidence of NV infection is distributed throughout the year. NV and RV infection had no significant difference in the number of diarrhea, the duration of diarrhea and the duration of vomiting, but the incidence of fever, vomiting, severe diarrhea (with symptoms of fatigue, drowsiness, mental weakness) in RV infection was significantly higher than that of RV NV infection (P <0.05), while runny nose and cough symptoms were more common in NV. Vesikari score of NV infection was (8.98 ± 2.94) points lower than RV [(10.45 ± 3.04) points, P <0.05)]. NV and RV infection more than 7 d improved, but prone to NV infection duration of the disease. Conclusions RV is still the main pathogen of acute diarrhea in infants and young children, but the detection rate of NV infection is also high. The NV infection is distributed throughout the year and the RV infection is still high in autumn and winter. RV infection has fever and vomiting, severe diarrhea is more common than NV, The NV infection with respiratory symptoms and easy to delay the course of the disease.