北京市5岁以下腹泻输液儿童病毒病原学分布及相关因素分析

Analysis on pathogen distribution and related factors of the diarrheal children under 5 years through intravenous infusion in Beijing City

目的 了解北京市5岁以下腹泻输液儿童的病毒病原学分布,探索病毒性腹泻相关因素。方法 2012年7月~2013年7月,应用横断面研究方法,在北京市3家儿童专科医院采集476份便标本,分别进行4种急性胃肠炎病毒检测,并对病原学分布及检测结果阳性的相关因素进行分析。结果 北京市5岁以下腹泻输液儿童急性胃肠炎病毒总阳性率为54.0%,4种急性胃肠炎病毒阳性率依次为轮状病毒28.8%,杯状病毒18.3%,肠道腺病毒10.7%,星状病毒4.0%。在高发季节发病,有呕吐症状,粪便性状非脓血便,非粘液便,便常规检测无白细胞,年龄在6个月以上的腹泻输液儿童,粪便检测出急性胃肠炎病毒的可能性较大。结论 儿童病毒性腹泻发病率不低于细菌性腹泻,值得关注。临床医生在秋冬季节发现无明显炎症反应,有呕吐的腹泻儿童,应首先考虑病毒性腹泻,少用或不用抗菌素。

Objective To know the pathogen distribution and the related factors of diarrheal children under 5 years through intravenous infusion. Methods From July 2012 to July 2013, 476 stool specimens were collected from 3 children hospitals in Beijing. The pathogen distribution and related factors of the children patients with positive acute gastvoenteritis viruses were analyzed. Results The total positive rate of acute gastroenteritis viruses was 54.0%. The positive rates were in the following order： RV 28.8%, HuCV 18.3 %, AdeV 10. 7%, AstV 4. 0%. Positive tests were mostly found in those children： who fell in high-occurrence season and with vomiting, elder than 6 months, without mucus, pus or white blood cell in the feces. Conclusions The morbidity of virus diarrhea was not lower than that of the bacterial diarrhea Correct diagnosis should be made in the children with nomiting and diarrhea in Autumn and winter by stool examination, as so to reduce the misuse of antibiotics.