新生儿肠道病毒感染临床特点与病原学研究

发布时间：2018-05-29 15:00

本文选题：新生儿 + 肠道病毒　；参考：《吉林大学》2012年硕士论文

【摘要】：目的：本研究旨在探讨新生儿肠道病毒感染的临床特点与病原学的相关性，特别是肠道病毒71型（EV71）、柯萨奇A组16型（CoxA16）、埃可病毒30型（E30）及副埃可病毒在新生儿中的感染情况；并了解其感染的临床特点及季节、年龄和性别的分布情况，以便早诊断、早隔离、早治疗。方法：采集2011年1月-12月584例新住院的新生儿的粪便标本，用逆转录－聚合酶链反应（RT-PCR）检测EV通用型、EV71、CoxA16、E30及副埃可病毒，出院时（住院14天），对部分肠道病毒感染的患儿再次检查EV通用型；同时采血进行血常规、血糖、肝功能、心肌酶等检查；并对临床资料进行分析。结果：2011年长春市儿童医院新生儿粪便标本肠道病毒通用型阳性检出率为11.98%（70/584），其中EV71阳性检出率为11.43%（8/70），CoxA16、E30和副埃可病毒均未检出；EV感染的季节分布，发病高峰月份为7～8月；性别分布：男女之比1.5：1；年龄分布：发病高峰年龄为20～28日龄；临床症状发热41例，58.57%；腹泻40例，57.14%；拒乳10例，14.29%；呕吐12例，17.14%；皮疹23例，32.86%；心肌损害（心电图心肌缺血、心肌酶增高）29.41%；神经系统并发症（惊跳/震颤/拒乳/嗜睡）22.86%，呼吸系统并发症（支气管炎、支气管肺炎）55.71%。复查的22例肠道病毒感染的患儿，EV通用型仍为阳性20例，阴性2例。EV71感染患儿，发热100%；皮疹6例，75%，皮疹为细小红色皮疹，3天左右消失，不留痕迹，，与婴幼儿手足口病例皮疹特点不同；所有患儿经治疗，均临床治愈出院，平均住院天数为8.83±1.79天。结论：1、新生儿中存在肠道病毒感染，2011年主要为EV71型感染；2、新生儿肠道病毒感染有明显季节性（7～8月份）；3、新生儿肠道病毒感染存在明显的高发年龄段（20-28日龄）；4、新生儿肠道病毒感染，主要表现为腹泻、发热、皮疹、循环障碍、心肌损害等表现，EV71感染患儿发热比例高；5、新生儿肠道病毒感染2周仍通过便中排毒。
[Abstract]:Objective: to investigate the relationship between the clinical characteristics and etiology of enterovirus infection in neonates, especially the infection of enterovirus 71, Coxsackie A group 16 (CoxA16), E30 (E30) and paracoviruses in neonates. The clinical characteristics, season, age and sex distribution of the infection were also investigated for early diagnosis, early isolation and early treatment. Methods: fecal specimens of 584 newborns from January to December 2011 were collected and detected by reverse transcription-polymerase chain reaction (RT-PCR). At the time of discharge (14 days in hospital, the children with partial enterovirus infection were re-examined for EV universal type; blood samples were collected for blood routine examination, blood glucose, liver function, myocardial enzyme and so on; and the clinical data were analyzed. Results: in 2011, the positive rate of enterovirus in fecal specimens of newborns in Changchun Children's Hospital was 11.98 / 584%, and the positive rate of EV71 was 11.43 / 80 / 70 CoxA16 / E30 and E30 respectively, and the seasonal distribution of EV infection was not detected, and the peak was from July to August. Sex distribution: male / female ratio 1.5: 1; Age distribution: peak onset age of 20 to 28 days; clinical symptoms fever 41 cases 58.57; diarrhea 40 cases 57.14; rejected breast 10 cases 14.29; vomiting 12 cases 17.14; rash 23 cases 32.86; myocardial damage (electrocardiogram myocardial ischemia) Myocardial enzymes increased 29.41%, nervous system complications (thrill / tremor / milk rejection / sleepiness 22.86), respiratory system complications (bronchitis, bronchopneumonia 55.71%), respiratory complications (bronchitis, bronchopneumonia, bronchitis, bronchopneumonia). In 22 cases of enterovirus infection, the common type of EV was still positive in 20 cases, negative in 2 cases, and fever in 100 cases. The characteristics of rash were different from those of infants with hand, foot and mouth disease, all the children were cured and discharged from hospital after treatment, the average hospital stay was 8.83 卤1.79 days. Conclusion there is intestinal virus infection in newborns, mainly EV71 type 2 infection in 2011. There are significant seasonal enterovirus infections in neonates in August of July and August. There is a significant high incidence of enterovirus infection in neonates at 20 to 28 days of age, and enterovirus infection in newborns. The main manifestations were diarrhea, fever, rash, circulatory disturbance, myocardial damage, etc. The rate of fever was 5% higher in children with EV71 infection. The infection of neonatal enterovirus was still detoxified in feces for 2 weeks.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.1

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