临床诊断细菌性痢疾区别于其他感染性腹泻相关因素分析

Identification of Bacillary Dysentery from Other Infectious Diarrhea

目的分析细菌性痢疾区别于其他感染性腹泻的相关因素,获得鉴别两者的主要区别点。方法将138例临床诊断细菌性痢疾与205例其他感染性腹泻流行病学和临床表现进行单因素分析,再通过多因素分析筛选鉴别两者的相关因素。结果细菌性痢疾平均体温(38.4±0.7)℃,其他感染性腹泻(38.1±0.6)℃(P=0.023);细菌性痢疾患者,里急后重和黏液便分别占34.1%和55.8%,比其他感染性腹泻11.7%和1.5%显著增加(P<0.0001);多因素分析发现,有里急后重患者患细菌性痢疾是无里急后重患者的3倍;黏液便患者是水样便患者的60.5倍;并且随体温的增加患细菌性痢疾比率增加。结论发热、里急后重和黏液便是临床诊断细菌性痢疾和其他感染性腹泻的主要鉴别点。

OBJECTIVE To obtain the primary differential items between bacillary dysentery and other infectious diarrhea through risk factor analysis. METHODS The epidemiology and clinical manifestation of 138 bacillary dysentery patients and 205 other infectious diarrhea patients were investigated. The Logistic regression was used to screen the correlation factors to differentiate bacillary dysentery from other infectious diarrhea. RESULTS The mean temperature of bacillary dysentery patients was （38.4±0.7） ℃, while that of other infectious diarrhea was （38.1±0. 6）℃ （P= 0. 023）. Bacillary dysentery patients with tenesmus and mucous stool were 34. 1% and 55.8%, respectively but of 11.7% and 1.5% of other infectious diarrhea patients（P〈0. 0001）. The possibility of clinically diagnosed bacillary dysentery increased along with the temperature of diarrheal patients raised, and the possibility when diarrheal patients with tenesmus were 3 times of with out tenesmus, and that with mucous stool were 60. 5 times of with watery stool. CONCLUSIONS Fever, tenesmus and mucous stool are the primary differential points between clinically diagnosed bacillary dysentery and other infectious diarrhea.