住院腹泻病患儿A组轮状病毒感染的流行病学和临床分析

发布时间：2018-04-17 00:11

本文选题：腹泻病 + 轮状病毒　；参考：《蚌埠医学院》2017年硕士论文

【摘要】：目的调查5岁以下住院腹泻病患儿A组轮状病毒(rotavirus RV)感染流行状况,比较分析其临床特征,从而更加深入地了解RV感染特征,为制定RV防治策略提供基础资料。方法收集蚌埠医学院第一附属医院2014-2015年5岁以下因急性腹泻而住院的患儿资料,胶体金法检测粪便A组RV抗原,对不同月份、年龄组、性别RV感染情况进行调查,并根据RV检测结果将腹泻患儿分RV阳性组和RV阴性组,对2组的临床特征包括腹泻、呕吐、脱水、发热、神经系统损害、呼吸道感染、严重程度及相关的实验室检测,包括乳酸脱氢酶(lactate dehydrogenase,LDH)、肌酸激酶(creatine kinase,CK)、肌酸肌酶同工酶(creatine kinase isoenzyme,CK-MB)、天门冬氨酸转氨酶(aspartate transaminase,AST)、丙氨酸转氨酶(alanine transaminase,ALT)等情况进行比较分析。结果(1)共850例患儿,301例RV阳性,总的RV感染率为35.41%;RV感染性腹泻全年均可发病,10-12月为RV感染的高峰期;不同年龄组RV感染率差异有统计学意义(χ2=80.993,P0.05);12-18月组感染率最高,为53.91%,总体上,RV阳性患儿中有265例(88%)为小于18个月;RV感染率男女性别间无显著性差异(χ2=0.375,P0.05)。(2)住院腹泻病患儿中RV阳性者比RV阴性者更易发生水样便(χ2=14.570,P0.001)、严重腹泻(χ2=5.931,P0.05)、呕吐(χ2=66.093,P0.001)、脱水(χ2=45.003,P0.001)、呼吸道感染(χ2=11.829,P0.05),差异有统计学意义。(3)与非RV感染性腹泻患儿相比较,RV感染性腹泻病儿童呈较高的Vesikari得分,差异有统计学意义(t=4.937,P0.001);RV阳性腹泻患儿组,重型腹泻发生率高于RV阴性腹泻患儿组,差异有统计学意义(χ2=21.430,P0.001)。(4)RV阳性组的LDH、CK、CK-MB、AST、ALT明显高于RV阴性组,差异有统计学意义(LDH:t=4.105,P0.001;CK:t=2.060,P0.05;CK-MB:t=5.463,P0.001;AST:t=3.423,P0.05;ALT:t=4.339,P0.001)。结论(1)RV感染是5岁以下儿童腹泻的重要原因,RV感染高峰发生在干冷的秋冬季,其感染率呈显著的年龄差异。(2)RV感染性腹泻病更易伴有水样便、严重腹泻、呕吐症状及肠外症状如脱水、呼吸道感染。(3)RV感染性腹泻比未感染RV的腹泻临床症状重。(4)RV感染对心肌及肝脏有一定程度的影响。应重视并加强RV感染的防治。
[Abstract]:Objective to investigate the prevalence of group A rotavirus rotavirus (RV) infection in children under 5 years of age, and to compare and analyze its clinical characteristics, so as to understand the characteristics of RV infection more deeply and provide basic data for the formulation of RV prevention and treatment strategy.Methods the data of children under 5 years of age who were hospitalized for acute diarrhea in the first affiliated Hospital of Bengbu Medical College from 2014 to 2015 were collected. The RV antigen in feces of group A was detected by colloidal gold method. The infection of RV in different months, age groups and sex was investigated.According to the results of RV test, children with diarrhea were divided into RV positive group and RV negative group. The clinical features of the two groups included diarrhea, vomiting, dehydration, fever, nervous system damage, respiratory tract infection, severity and related laboratory tests.Among them, lactate dehydrogenase, creatine kinase, creatine kinase isoenzyme, aspartate transaminase and alanine transaminase ALT were compared and analyzed.Results there were 301 cases of RV positive in 850 children, the total RV infection rate was 35.41%, the peak of RV infection was from October to 12 months, the difference of RV infection rate among different age groups was statistically significant (蠂 2 / 80.993P0.05 / 18 months), the infection rate of RV infection was the highest in the group of 12 to 18 months (蠂 2 / 80.993P 0.05 / 18), and the infection rate of RV infection was the highest in different age groups.There was no significant difference between male and female patients with RV infection rate less than 18 months (蠂 2: 0.375%, P 0.05%. 2) the patients with RV positive were more likely to develop water stool than those with RV negative (蠂 214.570 P 0.001), severe diarrhea (蠂 25.931 P 0.05, P 0.005), vomiting (蠂 2 6.093P 0.001, P 0.001).Compared with non-RV infective diarrhea, dehydration (蠂 2 + 45.003), respiratory tract infection (蠂 2 + 11.829% P 0.05) and non-RV infective diarrhea (P 0.001) had a higher Vesikari score than that of non-RV infective diarrhea.Conclusion RV infection is an important cause of diarrhea in children under 5 years of age. The peak of RV infection occurs in dry and cold autumn and winter. The infection rate of RV is significantly different in age. RV infection is more likely to be accompanied by water stool and severe diarrhea.Vomiting and extraintestinal symptoms such as dehydration, respiratory tract infection, respiratory tract infection, RV infection were more severe than those without RV infection.The prevention and treatment of RV infection should be emphasized and strengthened.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.1;R181.3

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