诺如病毒Ⅱ型感染儿童的肠道排毒时间及其相关因素的研究

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目的对诺如病毒Ⅱ型(GⅡ型)感染儿童的肠道排毒时间及其相关因素进行探讨,为诺如病毒的防控提供科学依据。方法对急性胃肠炎暴发疫情中经实时荧光定量反转录聚合酶链反应确诊为GII型阳性的51名儿童进行连续8周的随访和采样工作,收集研究对象的基本资料、临床表现以及诊疗情况,每隔7 d采集1次肛拭子进行核酸检测。利用生存分析的方法对资料进行分析。结果随访期所有对象第一周的排毒率高达62.75%,平均排毒时间为11.37 d,最长排毒时间为52 d。所有对象在第3 d、10 d、17 d、24 d、31 d和52 d的排毒率依次为62.75%、31.37%、13.73%、5.88%、1.96%和0,对男童和女童的排毒率、病例儿童和无症状的隐性感染儿童的排毒率分别进行Log-rank检验,差异均无统计学意义。感染儿童排毒的病毒载量随着时间的增加而下降(F=11.31,P=0.023)。Cox回归的结果显示就诊组的排毒时间短于未就诊组(HR=1.83,P=0.041)。结论病例儿童和隐性感染儿童之间的排毒时间无统计学差异,提示隐性感染儿童在诺如病毒传播过程中所起的作用不容忽视。去医院就诊使用药物后可能会缩短儿童的排毒时间。 Objective To investigate the intestinal detoxification time and its related factors in children with norovirus Ⅱ (G Ⅱ) infection and to provide a scientific basis for the prevention and control of Norovirus. Methods A total of 51 children with GII positive diagnosed by real-time fluorescence quantitative reverse transcription-polymerase chain reaction (PCR) in the outbreak of acute gastroenteritis were followed up for 8 weeks continuously. The basic data, clinical manifestations, The situation, once every 7 d collected anal swab for nucleic acid testing. Use survival analysis method to analyze the data. Results During the follow-up period, the detoxification rate of all the subjects in the first week was as high as 62.75%, the average detoxification time was 11.37 days and the longest detoxification time was 52 days. The detoxification rates of all the subjects on the 3 d, 10 d, 17 d, 24 d, 31 d and 52 d were 62.75%, 31.37%, 13.73%, 5.88%, 1.96% and 0, respectively. Detoxification of boys and girls Rates of detoxification in children with asymptomatic infection and asymptomatic children were Log-rank test, the difference was not statistically significant. The detoxified viral load in infected children decreased over time (F = 11.31, P = 0.023). Cox regression results showed that the detoxification time was shorter in the treatment group than in the non-treatment group (HR = 1.83, P = 0.041). Conclusion There is no significant difference in detoxification time between case and implicit children, suggesting that the role of latent infection in norovirus transmission should not be overlooked. Go to the hospital for medical treatment may shorten the child’s detoxification time.
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