181例急性腹泻患儿中的诺如病毒感染情况及临床特点分析

发布时间：2018-03-18 13:10

  本文选题：急性腹泻　切入点：诺如病毒　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:诺如病毒(Norovirus,NoV)是导致儿童病毒性腹泻的常见病原体,多见于小于5岁儿童。儿童NoV感染性腹泻常病情重,病程迁延,临床表现多样。本研究就我院181例急性腹泻患儿进行NoV病毒感染情况及临床特点分析,以加强对此疾病的认识,给临床一定的指导。方法:收集2015年1月~2017年1月在吉林大学第一医院住院,诊断为病毒性腹泻的患儿的粪便标本,提取病毒RNA,逆转录-聚合酶链式反应(Reverse transcription polymerase chain reaction,RT-PCR)进行基因扩增,琼脂糖凝胶电泳(agarose gel electrophoresis,AGE)检测诺如病毒。对患者的临床资料应用软件SPSS17.0进行统计学分析。结果:对收集的181例粪便样本进行检测,共检出NoV48例,检出率26.5%,其中GⅡ46例,GⅠ、GⅡ混合感染2例。NoV感染无性别差异性,男女比例为1.4:1,冬春季检出率高,婴幼儿高发。临床症状主要有腹泻(100%)、呕吐(68.8%)、发热(64.6%)、脱水(58%),也可出现腹痛、假性肠梗阻等,部分患儿病程中可伴有呼吸道感染症状(35%)。72.9%的患儿存在心肌酶升高,肝功谷丙转氨酶异常者少见。儿童NoV感染预后良好:治愈出院占35.42%(17/48),好转出院64.58%(31/48),住院中位数为6天。结论:1.GⅡ型为儿童主要NoV感染病毒株。2.儿童NoV感染无明显性别差异,具有季节性,以冬春季为主,3岁以下婴幼儿为高发人群。3.儿童NoV感染的主要临床表现为腹泻、发热、呕吐、脱水,也可有呼吸道感染症状。72.9%患儿出现心肌酶CK-MB升高,肝功ALT异常者少见。4.NoV感染目前无特效治疗,以支持对症为主,预后良好。
[Abstract]:Objective: Norovirus-Nov) is a common pathogen causing viral diarrhea in children, which is more common in children under 5 years of age. NoV infective diarrhea in children is often severe and the course of disease is prolonged. In this study, 181 cases of acute diarrhea in our hospital were analyzed for NoV virus infection and clinical characteristics, in order to strengthen the understanding of this disease, Methods: from January 2015 to January 2017, the fecal specimens of children with viral diarrhea were collected from the first Hospital of Jilin University. Virus RNAs were extracted, reverse transcription polymerase chain reactionation reverse transcriptase polymerase chain reaction (RT-PCR) was used for gene amplification. Agarose gel electrophoresis-AGEA was used to detect Norovirus. The clinical data of the patients were analyzed statistically by SPSS17.0. Results: 181 stool samples were detected and NoV48 cases were detected. The detection rate was 26.5%. There was no sex difference in G 鈪，

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