乳胶层析法检测腹泻患儿粪便轮状病毒和腺病毒结果及流行病学分析

Results and epidemiological analysis of stool rotavirus and adenovirus in children with diarrhea by latex chromatography

目的通过对丽水地区部分腹泻患儿轮状病毒(RV)和腺病毒(Adv)感染情况的分析,探讨本地区流行特征及发病规律。方法收集2016年1—12月来浙江大学丽水医院就诊的1 133例腹泻患儿粪便,利用胶体免疫层析技术,快速诊断患儿粪便里的RV和Adv抗原,分析轮状病毒、腺病毒和双重感染患者的性别、年龄和时间分布特点。结果 1 133例腹泻患儿的粪便中,检出轮状病毒222例,感染率为19. 59%;腺病毒23例,感染率为2. 03%;轮状病毒和腺病毒双重感染17例,感染率为1. 50%。男患儿轮状病毒阳性率为20. 18%(134/664)、腺病毒感染率阳性率为2. 79%(18/664)、双重感染的阳性率为1. 96%(13/664);女患儿为18. 76%(88/469),腺病毒感染率阳性率为1. 07%(5/469)、双重感染的阳性率为0. 85%(4/469),差异无统计学意义(均P> 0. 05);其中轮状病毒阳性率随患儿年龄增加而下降(P <0. 01),6～12月年龄组患儿轮状病毒阳性率最高(38. 05%)。本地区轮状病毒感染的高发月份为11月至次年2月,共检出阳性144例,占64. 86%(χ~2=57. 745,P <0. 001);腺病毒感染的高发月份是5～6月,共检出阳性14例,占60. 86%(χ~2=113. 900,P <0. 001);轮状病毒和腺病毒双重感染的高发月份是12月至次年1月,共检出阳性12例,占70. 58%(χ~2=24. 852,P <0. 001)。结论轮状病毒为本地区致儿童腹泻的主要病原体,并且发病具有明显的季节性,尤其要重视小月龄的婴幼儿腹泻感染轮状病毒和腺病毒的检查,选择快速准确的诊断方法,对于临床的诊治非常必要。

Objective To investigate the infection and epidemiological characteristics of rotavirus( RV) and adenovirus( Adv) in babies with diarrhea in Lishui. Methods The 1 133 cases of feces form children with diarrhea were collected from January to December 2016 in Zhejiang University Lishui hospital,and immunochromatography technique was used to diagnose RV and Adv antigens in feces of children,and the results were statistically analyzed. Results Among the 1 133 cases of diarrhea,222 cases of rotavirus were detected,the infection rate was 19. 59%. The adenovirus was 23 cases,the infection rate was 2. 03%,and there were 17 cases coinfection of rotavirus and adenovirus,the infection rate was 1. 5%. In male patients,the positive rate of rotavirus infection was 20. 18%( 134/664),the adenovirus was 2. 79%( 18/664),and double infection was 1. 96%( 13/664). In female patients,the positive rate of RV,adenovirus and double infection were18. 76%( 88/469),1. 07%( 5/469) and 0. 85%( 4/469),respectively. There was no significant difference in the positive rate of gender( P > 0. 05). The positive rate of rotavirus decreased with the age increase( P < 0. 01). The highest positive rate of rotavirus in children was 6 to 12 months. The highest incidence of rotavirus infection in this region from November to next year February,a total of 144 cases were positive,accounting for 64. 86%( χ~2= 57. 745,P < 0. 001);high incidence of adenovirus infection in May to June,14 cases were positive,accounting for 60. 86%( χ~2= 113. 900,P < 0. 001).The highest incidence of rotavirus and adenovirus double infection was from December to January of the following year,of which 12 cases were positive,accounting for 70. 58%( χ~2= 24. 852,P < 0. 001). Conclusion Rotaviruses are the main pathogens for children with diarrhea in the region,and the onset of virus infection has obvious seasonal change. In particular,paying attention to infants and young children with diarrhea infection with rotavirus and adenovirus,select a fast and accurate diagnostic method for clinical diagnosis and treatment are necessary.