济南地区秋冬季腹泻中轮状病毒及诺如病毒的感染分析

Analysis on rotavirus and norovirus infections among patients with acute diarrhea in autumn and winter in Jinan

目的：分析济南地区腹泻中轮状病毒（RV）及诺如病毒（NV）的流行状况，为腹泻的诊治提供依据。方法采集2013年及2014年9～12月济南市腹泻患者粪便标本579例，实时荧光定量PCR检测A组RV及GⅠ/GⅡ型NV，采用SPSS 13.0统计软件对临床及流行病学资料进行统计分析。结果579例腹泻患者中265例检测阳性，阳性率为45.77%（265/579）；其中A组RV阳性166例，阳性率为28.67%；GⅠ型NV阳性2例，阳性率为0.35%；GⅡ型NV阳性97例，阳性率为16.75%。感染RV和NV的病例中，男女比例分别为2.53∶1（119/47）及1.30∶1（56/43）；RV阳性病例年龄主要集中于2岁以下（80.12%），尤其是1岁以下幼儿所占比例最大（51.20%）；NV感染对象主要为小于2岁的婴幼儿（56.57%）及20岁以上成年人（38.38%）。RV和NV感染患者职业均以儿童及学生为主（90.96%和62.63%）；两者均以腹泻和恶心呕吐为主要临床症状（95.18%和84.85%）。结论 A组RV是2013-2014年济南地区秋冬季腹泻的主要病原体，GⅡ型NV也是引起散发性腹泻的主要病原；2岁以下幼儿是RV和NV感染的高危人群，NV还易引起成年人感染，腹泻和恶心呕吐为主要临床症状。

Objective To analyze the characteristics of rotavirus （RV） and norovirus （NV） infection among patients with acute diarrhea in autumn and winter in Jinan, and provide scientific evidence for prevention and control of the disease.MethodsStool specimens of 579 patients with acute diarrhea were colected in autumn and winter in Jinan 2013-2014, and the real time RT-PCR analysis was used to assay the rotavirus and norovirus. The epidemiological characteristics of laboratory confirmed cases caused by RV or NV were analyzed by SPSS 13.0.Results Among 579 stool specimens tested for RV and NV, the positive rate was 45.77% （265/579）. 166 （28.67%） were positive for RV, 2 （0.35%） and 97 （16.75%） were positive for GⅠ-NV and GⅡ-NV, respectively. Among the RV-infected cases, the most patients were male （71.67%）, and the most patient ages were less than 2 years old （80.12%）, especialy less than 1 year old （51.20%）. The high risk people of NV-infected were the infants less than 2 year old （56.57%） or the adults more than 20 years old （38.38%）. The occupation of positive patients with acute diarrhea were mostly children and students, and the main clinical features were diarrhea or vomiting.ConclusionsRotavirus is the most important pathogen for acute diarrhea among infants and young children in Jinan, and norovirus is also an important pathogen for the disease. The high risk people of RV or NV infected were infants less than 2 years old, while the adults more than 20 years old were also sensitive to NV. The main clinical features of RV or NV infected were diarrhea or vomiting.