银川地区儿童急性腹泻病的病原学及临床特点分析

Analysis of etiology and clinical feature of children's acute diarrhea in Yinchuan.

目的研究银川地区儿童急性腹泻的病原学及临床特点,为临床合理治疗提供依据。方法对急性腹泻病患儿的粪便进行细菌培养,同时采用RT-PCR技术进行轮状病毒、诺如病毒、扎如病毒、星状病毒及肠道腺病毒检测。就诊当天采集静脉血5 m L进行肝功能、肾功能、电解质及心肌酶的检测。结果 286份粪便样本共检测出病毒性腹泻172例(60.14%),细菌性腹泻36例(12.58%),急性非感染腹泻78例(27.58%),轮状病毒及诺如病毒是儿童急性腹泻病主要致病菌。病毒性肠炎主要症状有发热(56%)、呕吐(28%)、抽搐(17%)、皮疹(24%)、大便为稀水便(33%)、蛋花便(59%)、肝功能损害(40%)、心肌损害(33%)及肾功能损害。细菌性肠炎呕吐、发热较轻,大便性状为黏液脓血便(83%)、末梢血白细胞增高(75%)、超敏C-反应蛋白(CRP)增高(94%);非感染性大便为稀水样、黏液便多见,多合并呼吸道症状。结论银川地区儿童急性腹泻病以病毒感染为主,轮状病毒、诺如病毒为主要致病菌,不同类型腹泻病有不同的临床特点。

Objective To study the etiology of children with acute diarrhea and clinical features of Yinchuan, and to provide a reasonable basis for clinical treatment. Methods Fecal bacterial culture was used for detection for hospitalized children with acute diar- rhea and RT- PCR technology was used for rotavirus ,norovirus ,bar- like virus ,astrovirus and intestinal glands virus detection. 5ml ve- nous blood was obtained for detection of liver function, kidney function, electrolytes and enzyme tests. Results 172 cases of viral diar- rhea （60.14%） were detected in 286 stool samples,36 cases of bacterial diarrhea （12.58%） ,acute non -infectious diarrhea in 78 ca- ses （27.58%） ,rotavirus and norovirus were pathogenic bacteria of children with acute diarrheal disease pathogens in area;The main symptoms of viral enteritis was fever （56%）, vomiting （28%）, seizures （ 17 % ）, rash （24%）, stool water will dilute （33 % ）, egg flower will （59%）, liver dysfunction （40%）, myocardial damage （33%） and renal dysfunction. In bacterial enteritis ,vomiting and fever were mild, mucus stool for blood and pus （ 83 % ）, peripheral blood leukocyte （75 % ）, high - sensitivity C - reactive protein （CRP） increased （94%） in patients. Noninfectious watery stool, mucus were more common, and with more respiratory symptoms. Conclusion The viral infections is main pathogen in children with cute diarrhea, and rotavirus, norovirus are the main pathogens. Different types of diarrhea have different clinical characteristics.